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Archive for the ‘Education’ Category

It’s been almost a month since I updated my blog. I was extremely busy with the soft launch of my book as many orders were coming through my email. I am still working on getting these books into major bookstores in this country. At the same time I was also busy editing and preparing  a short movie for my hospital’s Annual Dinner this Friday. Numerous meetings were also conducted for the whole of this month as everyone is trying to do everything before the fasting month starts.

Over the weeks there have been many discussions in main stream media regarding the job status of medical graduates. As we all know the waiting period for Housemanhsip is close to 6-8 months from the time you graduate. Our Deputy DG came up with a brilliant idea that medical graduates should look for other jobs in the government. It seems that MOH is in talks with JPA/SPA to offer such jobs for those who are not interested in doing clinical medicine. Shouldn’t it be decided before someone spend 5 years and money to do medicine! That’s the reason I finally decided to publish a book to educate the public/students on reality of being a doctor. It also confirms yet again that we are short of post. The worst is yet to come as the number of medical officer post is coming to almost NIL. I was informed that nursing post are being borrowed to convert to MO post. 4 nursing post is being converted into 1 MO post. Meanwhile, as expected, another 5 years moratorium will be extended starting this year, expiring in 2021.

2 days ago, there was an interesting letter written to TheStar by a Russian university student(see below). I had always maintained that all good students should be offered a place in local universities. Cases such as this is nothing new. Being in the same shoe many many years ago, I just had to take the more difficult path of doing STPM to get into UM medical faculty. Trust me, the more difficult path that you take, the better person you become. Those who enjoy smooth sailing life are the one who will fall apart, the moment life gets tougher. While he should have done his homework before falling into the hands of these unscrupulous agents, the situation in some of the Russian medical schools is nothing new. I had spoken to many who graduated from certain Russian medical schools and what this letter has described is exactly what they had told me. However, there are some Russian schools which are better. This is the reason why I keep telling all budding doctors that they should know what they are getting themselves into.

Whatever said, life is never easy. Most students do not know what life is at the time they pursue their studies as they have been supported by parents all the way. Only when they join the work force they realise how difficult life is. We are living in a capitalist world where people will do whatever they need to make money. That is what the agents and some medical colleges are doing. Our ignorant society is partly to be blamed. Unfortunately, I still see and hear multiple advertisements on papers and radio promoting easy route to fulfill student’s dreams in doing critical courses such as medicine, dentistry, pharmacist etc! The government on the other hand never takes any action as long as there are no complains. Which student will complain to get themselves into trouble? That’s why I salute this student for being bold and brave enough to tell what is happening, in a main stream media. I am sure he has genuine passion to be a doctor but life never gets any easier………

 

 

Plea from Russian grad

Soon to be graduating from a Russian medical faculty myself, I would like to share my thoughts on where we went wrong and how we should stop traumatizing our students studying in “incompetent” medical schools.LATELY, comments about incompetent medical graduates returning from overseas after completing their studies have been all over social media. Medical students especially from Russian medical schools cannot help but feel stigmatized every time they view these reports.

I became interested in medicine when I was eight years old after seeing my uncle collapse in front of me. He was declared brain dead a week later and I watched family members fumble for answers. I also saw my grandmother deteriorate to an unrecognizable state from cancer.

I come from a small town where English was hardly spoken outside of lessons in school. My parents are educators and both encouraged me to pursue medicine. I did very well in school, debating both in English and Bahasa Malaysia at state level, played hockey, was president of every club I could join and still maintained my grades with almost perfect scores.

I excelled in my SPM examinations, applied for all the government scholarships – JPA, matriculation, IPTA – and anything that could put me on my path to medicine. It was really heartbreaking to get no reply or just plain rejections without any reason.

And then the “leeches” came in. Unscrupulous, greedy and dishonest agents recruiting for medical institutions in countries like Russia, Ukraine, Indonesia and the Middle East see the opportunity to take advantage of a student’s dream and their parents’ desperation to fulfil that ambition.

I was 18, uninformed, fearless, and just desperate to see a path where medicine would be in sight. I jumped on the bandwagon, backed up with promises and hopes from agents and even family members studying in Russia. I should have been more careful or talked to more people but all I could think of was realising my dream of becoming a doctor without killing my parents who were already mortgaging everything they owned to send me to Russia.

In Russia, we were cramped in hostels with six people in a two-person bedroom, lived out of suitcases and were yelled at every day because we didn’t understand the language. When we tried to ask the agents for help, we were turned down unless we could provide a large sum of money for “handling fees”.

Believe me, I asked myself every day if I had made the right choice. I felt lost and helpless in a land where people didn’t think twice about telling you to pack up and leave. But if I called up my parents to tell them I wanted to come home, the money they spent on my first year tuition fees, plus my airfare, accommodation and documentation fees would be all for nothing.

So I learnt the local language, went for every class and painstakingly tried to communicate with local patients who would turn you down or tell you to your face that “you foreigners don’t belong here”. Humiliated and broken, it wasn’t easy to keep the passion for medical knowledge burning.

Students here develop immunity to criticism, yelling, being called names and marginalized. Some resort to drugs, partying and extreme socializing to mask the depression and frustration of being “outcasts” in this country.

On top of this, we don’t have the opportunity to pick up practical skills because, to put it bluntly, the university here doesn’t care if we graduate as incompetent doctors as we won’t be serving their citizens. It’s sad because there is excellent potential here, and given the right education and guidance, the students can be outstanding doctors.

When we do our practical rotations in summer in Malaysian hospitals, the first question asked of us is where we are studying. And we watch as the facial expressions show the disgust or distrust after we say Russia. And listen as the HOs, MOs, specialists and local medical students snicker about how we are the black sheep of the system.

Can you even try to comprehend the stigma that surrounds us? We suffer every day in extreme weather and social conditions here, only falling back for support from other Malaysians who are equally lost and trying to survive.

Were we told that the syllabus was in English and we would be given a well-rounded education? Yes. Is this the reality? No!

There are students here on government scholarship or Mara loans who have no passion for medicine. They do the bare minimum just to pass and go on exclusive trips to Europe or buy expensive gadgets. Some have even set up small businesses here.

Then there are the super rich Malaysian students who couldn’t qualify for other medical institutions. Forced into doing something very difficult, they skip lessons, do the bare minimum and still graduate as doctors.

Today, barely a month into graduating, I am writing this letter hoping for some guidance and compassion in dealing with medical graduates like me who are coming back already disheartened. We seek refuge in our own country, the very country we are proud of and want to come back to, to serve its citizens.

SOON TO BE DOCTOR

Pahang

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I had always maintained that doctors should not discuss cases openly in social media, especially in Facebook etc. I use to see many of such post which I had never contributed. I did write about this before. When I first started this blog in 2010, there were many students and junior doctors who asked me why I am not using this blog to educate the doctors on interesting cases etc. While I do give talks during CME sessions in JB and had also been Johor MMA CME Chairman for 2 years (2013-2015), I had always felt that social media is never a good platform. In this blog I had only given some examples of common mistakes by junior doctors who could lead to major complications to patients. I had also used some examples to show how doctor’s life is not as easy as what the public assumes. But I had never used this blog to discuss cases openly or posted any pictures of patients.

Case discussion should only be for medical personals. Even though we do not mention any names or details, it is open for public viewing and as such, the patient can sue you if he/she had not given consent. This is more so for pictures or videos. The popularity of WhatsApp, BBM and Telegram had further contributed to this. Doctors are now sending patient’s particulars, history and pictures to other doctors for discussion purposes. Of course it is a quick way of getting help from consultants etc but these pictures should never reveal any of the patient’s information or the patient’s face.

Finally, MOH had produced a guideline on the use of social media among medical personals. The Guideline, released on 31/03/2016 clearly says that Facebook, Instagram, Blogs, Twitter and You Tube are banned from being used as medium of discussion. You can view the guideline here :Pekeliling Media sosial. The Star had also reported on this issue.

Unfortunately, this guideline does not prevent the patients from making remarks or comments on doctors/hospitals in social media. We see a lot of such comments in Facebook etc. In fact, I have had patients in my hospital threatening the hospital management by saying that they will viral the issue on social media! But as doctors, bound my MMC’s professional and ethical conduct, we just have to keep quiet and do our work to help people…………… Any emotional rant will lead to MMC’s disciplinary enquiry!

Doctor’s life never gets any easier…………………..

‘Don’t discuss patients online’

BY SARBAN SINGH

SEREMBAN: Social media may be the “in” thing for Malaysians nowadays to post instant alerts but not for doctors.

Doctors in government service have been told not to discuss their patients’ medical issues on social media such as Facebook, Twitter or Instagram to prevent breaches in confidentiality.

Neither should they carry out clinical consultations on these platforms where such information could be accessed by other people, said Health Ministry director-general Datuk Dr Noor Hisham Abdullah.

The order came about to minimise the risk of ethical and legal complications and to uphold the integrity of the medical profession, he said in a circular.

“Social media sites cannot guarantee confidentiality with whatever privacy settings currently in place.

“Once information is published online, it can be difficult to remove it as others may have already distributed it further, thus easily breaching patient confidentiality,” he said.

He explained that the directive came about as more health care providers were using social media in their work.

However, Dr Noor Hisham said doctors could set up a social media platform for group consultation provided there was a “moderator” and there was a profile of the members and where the content of the conversation was not accessible to public.

“However, the uploading and transmitting of still images or in video format should not include any information which could reveal the patient’s identity,” he said.

Doctors in such group consultation must also get written consent from their patients before uploading any information about them on social media.

“The only exception would be in an emergency where the patient may not be able to give consent,” he said, adding that doctors were responsible for the confidentiality of any information they send out via social media.

Dr Noor Hisham said doctors were also duty-bound to delete all stored information of their patients in their mobile devices after the completion of the consultation.

All personal information or images from any consultation could not even be used for the purpose of health education to others.

“Social media platforms cannot be used for referral cases as they include patient-identifiable information,” he said.

Despite the advantages of social media, Dr Noor Hisham said doctors should always opt for direct consultation or over the telephone whenever possible.

In cases of emergencies, he said doctors or other healthcare providers were supposed to consult their peers over the telephone first before opting for the social media.

Pekeliling Media sosial

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Finally, the government aka JPA has announced the new scheme for scholarship. As expected, the numbers has gone down and overseas scholarship is being reduced. When the bursary program was announced in 2012/2013, it was an election goody. Somehow I knew it may not last long. Those who benefited are the lucky ones. Personally I feel we should stop giving scholarship based on SPM results. SPM is never a pre-university course. WE should standardised our Pre-University courses and use that as the University entry and scholarship requirement. Unfortunately, in the name of education hub, there are simply too many pre-university courses being conducted in Malaysia. This has resulted in agencies, including MMC to use SPM results as the main university entry requirement.

I had always felt that the best students should be retained within the country. However, it should be in public universities. Unfortunately, selection of students into public universities are always biased based on certain constitutional rights. Education should never be commercialised. WE can see the outcome of this commercialisation with the quality of graduates being produced nowadays. This in turn will also affect the public universities’ quality as it is never based on merit. We have just too many higher institution of learning with too few academics. We have more medical schools than what UK has for double the population.

Well, for this year, only 250 students will be selected for bursary. None from next year. Only top 20 students will be given overseas scholarship which I think is fair enough. They must return to serve the civil service. 200 special scholarship for engineering courses are still maintained. The local undergraduate scholarship will be given as loans. Graduates are required to repay 25 per cent of the loan amount if they work with government-linked companies; graduates are required to repay 50 per cent of the loan amount if they work in local private companies; and graduates are required to repay the entire loan amount if they choose to work abroad. For those who join the public service sector, they should serve within a certain period of time according to their field of work, for example within six to seven years for engineering and over 10 years for the medical field. 

Personally I feel it is a fair criteria but does the same rule apply for scholarship offered by other bodies such as MARA, State governments, Majlis Agama etc?

*** update 9/04/2016: as expected, the government announced that all 2015 top SPM students will receive bursary to study locally****

Fewer overseas scholarships

BY CHELSEA L.Y. NG

PUTRAJAYA: The bulk of SPM top scorers who apply for Public Service Department (PSD) scholarships can forget about studying in top universities around the world.

They will have to make do in local universities.

The privilege of choice overseas study will be reserved only for the best 20, according to the Public Service Department (PSD) which is the country’s largest provider of scholarships and bursaries for post-secondary education.

In a media briefing here yesterday, a PSD senior spokesman said only 20 of the “creme de la creme” would be allowed to study in top ranking universities abroad and return to join the civil service.

“It is part of the long term plan to inject the civil service with quality graduates who will in turn be quality civil servants.

“They will be groomed to be our civil service’s next generation of leaders,’’ the spokesman said.

He said an additional 200 top students would have places under the Special Engineering Programme but would only be allowed to study in Japan, Korea, Germany and France.

On the new funding regulations, the spokesman said that studies in local public and private universities will be given priority.

“We cannot be having all our finest and brightest study outside the country as it does not reflect the aim of having outstanding students in our local institutions,” he said.

The spokesman also announced that there will be no more Bursary Graduate Programme from next year onwards.

For this year only 250 SPM leavers with 9A+ from 2015 will be offered funds through the bursary programme to study locally.

As for some 744 students, who qualified for the bursary programme in 2013 and 2014 and were hoping to study abroad, they will now have to do their degrees in local public and private universities.

The spokesman advised the 744 students not to be disheartened.

“You can’t get what you want all the time, just like everyone wants to be a CEO but that is impossible,’’ he said.

“The focus is on funding more people to get into the varsities here. The quality of our varsities have improved,” he added.

Stressing that the Government was trying its best to offer as many scholarships as possible from the RM1.65bil pool announced in Parliament recently, the spokesman said there was also the additional allocation of RM160mil approved under the recalibrated Budget 2016 to fund this year’s batch of students.

This amount, which came following the Budget 2016 revision announced in January, is meant to support 49,060 students, with 41,324 (84%) of them studying here, and the remaining 7,736 overseas.

He said among the criteria that will guide the PSD in its selection process were merit and the socioeconomic background of the applicant, besides grades and co-curricular achievements.

The spokesman said the department will also focus on those categorised in the B40 and M40 groupings, with attention on technical & vocational education and training (TVET).

(B40 refers to the bottom 40% of households in the country who typically live on a monthly household income of under RM3,860, while M40 refers to those from households with monthly incomes of up to RM8,319)

A thousand students from B40 families will be offered the Dermasiswa B40 to pursue diplomas in polytechnics and public universities, including Universiti Tenaga Nasional and Multimedia University, he said.

Seven thousand university students, who are currently pursuing their studies in local public and private institutions of higher learning, will continue to benefit from PSD funding.

The spokesman added that a special briefing for 2013/2014/2015 Bursary candidates will be held soon, although no specific date was mentioned. More information can be found at esilav2.jpa.gov.my or by calling 03-88853603/3777/3398.

PSD introduces new sponsorship model

Tuesday April 5, 2016
10:32 PM GMT+8

PUTRAJAYA, April 5 — The Public Service Department (PSD) has implemented a new student sponsorship model this year, including the introduction of a sponsorship programme for 1,000 students from the B40 families.

(B40 relates to bottom 40 per cent household income) Besides the B40 Dermasiswa programme and five other sponsorship schemes, the new model also requires students to sit for the Cambridge Online Test (COT), to evaluate the applicant’s personality and tendencies.

A senior PSD officer said overall, the new PSD sponsorship model was drafted based on four key thrusts, namely merit and inclusivity; focus on the B40 group, M40 and the Technical and Vocational Education Training(TVET); development of Malaysia as an education hub; and, return on investment (ROI).

“The new model focuses on the sponsorship of students to local higher learning institutions to retain the brightest students in the country, thus supporting efforts to make Malaysia a regional education hub,” he said.

Five other sponsorship programmes are the National Scholarship Programme; the Special Engineering Programme to Japan, Korea, France and Germany; the Local Undergraduate Programme; the Post-Bursary Programme; and the Bursary Programme.

He said to ensure commensurate returns, starting this year, sponsorship would be implemented in the form of variable rate loans except for the Dermasiswa B40 programme.

The sponsorship agreement will be subjected to four conditions, namely loans can be converted into full scholarships and are exempted from repayment if graduates serve in the public service.

Graduates are required to repay 25 per cent of the loan amount if they work with government-linked companies; graduates are required to repay 50 per cent of the loan amount if they work in local private companies; and graduates are required to repay the entire loan amount if they choose to work abroad.

“For those who join the public service sector, they should serve within a certain period of time according to their field of work, for example within six to seven years for engineering and over 10 years for the medical field,” he said.

The PSD officer said for the Dermasiswa B40 programme, sponsorship would be given to 1,000 students to pursue diploma studies in polytechnics, public universities, Universiti Tenaga Nasional (UNITEN) and the Multimedia University (MMU) in the TVET field.

“It is estimated they will receive a minimum sponsorship of RM25,000 for a duration of three years,” he added.

He said the selection of students for the B40 Dermasiswa Programme was made, among others, through the National Poverty Data Bank or eKasih list, students from households with monthly income of RM3,690 and below and consideration on household income based on states and localities.

“This is part of the government efforts towards realising the highly-skilled talent development to meet the needs for skilled workers in the future.” On the National Scholarship Programme, he said 20 best Sijil Pelajaran Malaysia (SPM) 2015 holders would be sponsored to study at top universities worldwide.

He said the sponsorship would cover the preparatory courses in the country, that were limited to certain fields, designated by the government.

For the Special Engineering Programme to Japan, Korea, France and Germany, the PSD officer said it would be given to 200 SPM 2015 holders, who were interested to take up a diploma or bachelor’s degree programme in engineering in the three countries.

The sponsorship would also include preparatory courses taken in the country, he added.

He said under the Local Undergraduate Programme, sponsorship would be given to 7,000 students to pursue their studies in public universities, UNITEN, MMU and Universiti Teknologi Petronas (UTP).

PSD will continue the Post-Bursary Sponsorship Programme for 744 Bursary Programme 2013/2014 (SPM 2012/2013) students, in order for them to pursue their first degree at local universities set by the government.

Under the Bursary Programme, he said sponsorship would be given to those who obtained 9As+ and above in SPM 2015, with the selection of recipients based on merit and inclusivity.

According to the PSD officer, the sponsorship is focused on the fields of clinical and health, engineering and technology, and science and social science.

“The Bursary Programme that was previously handled by the Education Ministry will be implemented by PSD on a one-off basis and for 2016 alone. This programme will not be continued, beginning 2017,” he said.

Meanwhile, he said a special briefing session with the Bursary Programme 2013, 2014 and 2015 students would be held in the near future.

Students involved can refer to the PSD’s portal at http://esilav2.jpa.gov.my or contact 03-88853603/ 3777/ 3398 for more information regarding the briefing.

Overall, he said the JPA was continuing its sponsorship programme with an allocation of RM1.65 billion for 49,060 students comprising 41,324 students locally and 7,736 students abroad.

An additional allocation of RM160 million has been approved under Budget 2016 to finance the sponsorship of new students in 2016. — Bernama 

– See more at: http://www.themalaymailonline.com/malaysia/article/psd-introduces-new-sponsorship-model#sthash.QyEIwPS1.dpuf

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Here we go again. It is the month where both SPM and STPM results are announced. I will usually see a surge in my blog visits and various comments and emails will be sent to ask for advise. Despite all the answers being available in this blog, people simply don’t read. They expect to be spoon-fed like their school days.

Today, The Star wrote several reports on unqualified students going abroad to do medicine (see below). Yes, it is still happening and agents are still going after our “uninformed and ignorant” society who determined to make their child a “Dr” by hook or crook. Just take a look at one of the emails I received today (the student did not fulfil the minimum SPM qualification):

we went to edu fair held in midvalley n met some ‘experts’ from XXXX  college. Whr he guaranteed 100%seat confirmed in Indonesia,India .Russia.Poland ..N etc…no need repair xxxxxx results…Foundation in 6 months n can enter any university of our choice in Indonesia by August 2016.

So, what The Star reported today is the reality. Many fall into this trap. Let me inform you guys that first of all I DO NOT consider SPM as a university entry exam. It is NOT a pre-university course. The reason why MMC has to come up with this is due to the fact that we have too many dubious foundation courses being conducted by the colleges. The exams, marking scheme and standards are set by the colleges themselves with no standardisation. Only standardised Pre-U courses like STPM, Matriculation, A level, IB etc can supersede SPM results. With the standards of SPM nowadays where thousands can score 8As, why are we even considering “Bs”!! Unfortunately, MOE did not want to increase the requirement to 5As as suggested by MOH and MMC. It is all about politics in Malaysia!

Please be informed that due to shortage of post, MMC has clearly informed that only after SPA offers you a job, you will be given the Temporary Registration. SPA has been given the task to filter the candidates. So, those who do medicine without NOC aka minimum requirement, will likely not get a job for housemanship. Those who go to unrecognised university will not be able to sit for MQE examination if you do not possess the minimum qualifications. I hope ignorant parents and students will understand this before spending huge amount of money.

Then , there was this grandiose suggestion by MOE (not MOH !!) that private hospitals should be considered for housemanship !!. Why the hell is MOE talking about this in the first place? They have no jurisdiction in deciding which hospitals should be used for housemanship etc. It is MOH and MMC who decides. MOE has realised that they had messed up the entire medical profession in the name of education hub. BUT yet, they still do not want to admit the fact. Giving licences to shop-lot medical schools and only concerned about their KPI which is all about the numbers!

I had written about using private hospitals as housemanship training in November 2015. It is not feasible as the system does not allow it to be used as such. Our DG has made some statement in his Facebook page as below:

Screen Shot 2016-03-19 at 6.56.49 PM

Firstly, people must understand how private hospitals function. Consultants are not employed by the hospital. There are NO MOs for inpatients. MOs are only stationed to run the emergency department. Almost 90% of patients are paid by employees or medical insurance cards. Majority of patients come to private hospitals for comfort and to be treated by specialist/consultants. Private hospitals are profit driven. Any new private hospital will take at least 3-5 years to break even and another 3-5 years to get return of investment. So, it is almost 100% impossible to fulfil the criteria stated from (b) to (e)!! No private hospital is going to pay an HO a salary and indemnity insurance as it will be considered as wasted money. What do they get in return? No private hospitals are going to employ MOs in each department. IN private hospitals, no patient is going to allow an HO to clerk, examine, investigate and start initial treatment. They come for specialist treatment. No insurance company is going to pay for HO’s fee! Even paying consultant’s charges are being strictly regulated by insurance companies despite already regulated by the government! Which consultant is going to have enough time to supervise these housemen? Working in a private hospital for the last 6 years just tells me that I would not even have time to talk to a houseman if I have any!

4 years ago, i wrote on issues where many private medical colleges were planning to have their own teaching hospitals. I gave my thoughts on the issue and why students should be careful in listening to the college’s marketing guys. None of these promised private teaching hospitals has materialised as of today (Monash, IMU, AUCMS, UCSI, Perdana). The reasons are simple! It is the same as above. I understand UTAR and MSU are now in the process of building a private hospital. No private hospitals employ medical officers to run their inpatient or outpatient services. It is all specialist driven. All patients are paid by insurance. I know one private medical college which has bought over a private hospital but did not use it for teaching medical students. Reality is different and using it for teaching medical students may be suicidal to their reputation. Building a hospital and running it are 2 different issue. It is very much easier to build but to get the return of investment is totally a different story. No private hospital is going to spend money on unnecessary expenses which include paying HOs and MOs. They are not charity organisations. The medical cost is escalating exponentially.

It looks like MOE, MOH and MMC are blaming each other! For years I have been talking about this but no one bothered. I was actually invited to moderate the forum between MMI(Malaysian Medic International) and DG yesterday but I was only informed about 2 weeks ago. I was unable to make it as my mother’s knee replacement surgery was last week and I had to take leave for that.

May the drama continue………….

Not cut out to be doctors

BY CHRISTINA CHIN

PETALING JAYA: Desperate to do medicine, many unqualified Malaysian students are going abroad to get their degrees.

Ministry of Higher Education (MOHE) director-general Datuk Prof Dr Asma Ismail said the ministry was asked to verify the SPM results of a batch of students currently enrolled in a foreign university in the region.

“The university wanted to know if the students met the ministry’s minimum requirement for a ‘No Objection Certificate’ (NOC).

“We checked and found that they did not qualify. There are, however, no reports of fake or forged documents,” she told the Sunday Star.

Dr Asma, however, declined to reveal the number of students involved and the location of the university.

She was responding to claims that students with Ds and Es for science subjects, those from the arts stream, those without the NOC and those who failed the entrance exams, were among those studying medicine and dentistry abroad.

The Sunday Star received complaints that unscrupulous agents here could be falsifying SPM result certificates and NOC.

Students wanting to pursue medical courses overseas must get NOCs from the ministry.

The issuance of the certificates is based on the students having the same minimal entry qualifications as stipulated for entry to local universities.

“We are aware of unqualified students going abroad but we cannot take action as it’s beyond our jurisdiction. The intake of students is handled by the universities abroad.

“We have dealt with complaints of document falsification in the past. The ministry has lodged police reports and the cases are now under police investigation,” she said.

Dr Asma said falsifying official government documents was a serious offence, adding that anyone with information on forged or fake results should report to the MOHE, or in cases of SPM certificate forgery, to the Education Ministry, so that action could be taken.

The Malaysian Medical Association wants the Malaysian Medical Council (MMC) to investigate the allegations.

Its president Dr Ashok Zachariah Philip said the complaints exemplified loopholes in the system.

“Under the existing law, the Health Ministry must give Malaysians with recognised degrees posts for housemanship.

“The problem is when unqualified students do medicine in less discriminating colleges.

“Given that these colleges are willing to bend the rules and may not have good facilities or faculties, the shortcomings of less qualified students won’t be addressed,” he said.

On Tuesday, the MMC urged MOHE to impose more stringent entry requirements for medical courses to arrest the deteriorating standards of foreign university graduates.

In response to The Star’s articles on the medical graduates’ glut and poor performance of graduates from some medical schools abroad, MMC president Datuk Dr Noor Hisham Abdullah said minimal entry qualifications for undergraduate courses were determined by the ministry.

Dr Noor Hisham, who is also Health director-general, said MMC monitored local university students without minimal qualifications but did not have the authority to regulate their entry into medical courses in universities abroad.

He said many foreign universities ignored the NOC for minimal entry qualifications and took in students with lower qualifications or circumvented the requirement by conducting their own foundation courses, many of which were found to be of dubious standards.

Faking it for medicine

BY CHRISTINA CHIN

A UNIVERSITY in a neighbouring country is accepting unqualified students for its medical and dentistry programmes, a student who only wanted to be known as Jade, 21, claims.

There’s a lot of hanky-­panky going on, she suspects, alleging that a college in the Klang Valley sends students with Es and Ds in their ­science subjects to study there.

“The college – an agent for the university – told my friend with poor SPM results not to worry as it could easily be taken care of. Even the Higher Education Ministry’s (MOHE) Non-Objection Certificate (NOC) can be bought, although most Malaysian students there don’t have it. Arts students are also allowed to take up medicine and dentistry there,” she claims, sounding shocked.

She says many of her friends are struggling there because the syllabus and exams are not in English, despite being told otherwise.

Thina, 23, who paid a “large sum” to the college, backs the claims. He says he did not verify with the authorities claims that the university is recognised. At the time, all he could think of was the excitement of leaving to study abroad.

“Some aren’t even ­science stream students and they don’t have the NOC. I won’t be surprised if the number of qualified students are one out of 50. The college lures these unqualified students by assuring them that poor SPM results don’t matter and that the NOC can be bought for less than RM20,000.”

Although qualified to study medicine, he’s surprised that he “somehow got in” despite being unprepared for the university’s entrance exam. The Penangite, currently studying in another higher institution, left the university in his third semester.

The university’s system is extremely bad and students have to put up with rude and unprofessional lecturers, he complains, lamenting how even basic classroom facilities like fans, are non-existent. Alleging that fees were increased without notice or explanation, he says the college had promised to sort the matter out but later washed its hands.

“There’s no time limit to graduate – you can take up to nine years even, especially in the dental faculty. They assured me that I’d be able to complete my studies within 5½ years but I realised many were stuck up to seven or eight years. I’d rather not take my chances graduating from a university like that,” he shrugs.

Since 2012, there have been many complaints against the college and university on complaintsboard.com.

“Malaysians must be warned. I’m sure students studying there won’t come forward because they themselves aren’t qualified and wouldn’t want the Government to know.”

Urging the Government to act on the errant education providers, Jade worries about the quality of future healthcare professionals. She thinks it’s pointless for smart, hardworking students to pursue medicine or dentistry as “anyone can get in now”.

Brushing off the “baseless accusations” as the work of jealous competitors, a spokesperson for the college says it no longer recruits students for the “world-class university”, preferring to focus on its own courses and other local institutions.

“We don’t recruit students any more but because of our long-standing relationship, we help book examination halls for the university’s prospective candidates – that’s all. The university selects the students and handles all the paperwork. We’re not involved,” he clarifies, stressing that “such an established university wouldn’t accept fake or forged SPM certificates”.

“The university has a website. Everything is on the Internet. Do you think it’s so easy to fool people nowadays?”

Malaysian Medical Association president Dr Ashok Zachariah Philip wants the Health Ministry to consider a Clinical Aptitude Test for prospective medical and dentistry students. The law, he says, must be amended to ensure that anyone circumventing this requirement would not be employed by the Health Ministry.

Students must have the minimum qualification to read medicine whether locally or abroad, or there may be consequences particularly in employment opportunities later on, Health director-general and Malaysian Medical Council president Datuk Dr Noor Hisham Abdullah warns.

The MOHE cautions: Parents must be vigilant when choosing which university to send their child to. Do thorough research. There are many options out there that suit your child’s interests and qualification.

Additional student intakes and new programmes must stop

BY LOH FOON FONG

KUALA LUMPUR: The moratorium imposed on new local medical schools over the past five years has not stopped the intake of more medical students.

This is because existing schools came up with new medical programmes and increased students’ intake, said Health director-general Datuk Dr Noor Hisham Abdullah.

For this reason, he urged the Ministry of Higher Education (MOHE) to not only extend the moratorium but also put a stop to new programmes and additional student intakes.

“We are not happy with just the moratorium. We want it to be extended with no more new programmes and no more increases in student intake,” he said at the Malaysian Medics International forum’s dialogue with the Health Ministry and Malaysian Medical Council (MMC) here yesterday.

Dr Hisham, who is also MMC president, said some schools had come up with multiple programmes with twinning arrangements overseas.

“From one course, they can have four or five programmes and incre­ase the number of students,” he said.

Asked why local schools were allowed to increase their medical programmes as the Higher Education Minister in 2011, Datuk Seri Mohamed Khaled Nordin, had imposed the freeze, Dr Hisham said the moratorium was only for new medical schools.

The moratorium was effective from May 1, 2011 and would end April 30, this year.

MMC member Datuk Dr Abdul Hamid Abdul Kadir said there had been cases where MMC’s decision to cut down on the number of medical students had been overruled.

In one case, the MMC had allowed only 60 students instead of 100 for a local university based on its capacity for an offshore programme but this was overruled.

In response to the Higher Educa­tion director-general Datuk Prof Dr Asma Ismail’s statement on Friday that the numbers approved were determined by MMC and not the MOHE, Dr Hamid said it was not entirely true as it was a collaborative effort and MMC’s decisions had sometimes been reversed.

Dr Hamid said that it was crucial to cap the number of students especially with private universities because students there were crowding public training hospitals.

Asked if anything could be done about students who took up medical studies despite not meeting the minimum grades and circumventing the No Objection Certificate (NOC) they were supposed to get from the MOHE, Dr Hisham said the authorities might have to consider making it legally binding as there was no law to address this now.

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I have been working on this for the last 8 months…………

Details will be revealed soon………………..

Something coming..............

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As the reality finally comes out of the closet, there has been several new updates on the “jobless” scenario of medical and dental graduates. It is also made known that pharmacist graduates are also waiting in the “Q” for their internship in civil service. In the typical Malaysia Boleh style, our government has once again proven how screwed up our human resource planning is. Knee jerk reactions to everything! We will not be in this mess if a proper human resource planning has been done and each ministry communicated with each other. Unfortunately, we were only interested in numbers and ratios. Nasi sudah menjadi bubur!

3 days ago, after some news reports, our DG issued a press statement on the situation of dental graduates. In June 2015, I did write about the situation of dental graduates when the government decided to reduce the compulsory service to 1 year. This year, the situation has become worst as more and more dental graduates begin to graduate, similar to our medical graduates. Most dental schools which started about 5 years ago, begin to produce graduates from last year. Our DG has admitted that we are in a dire situation. Almost 99% of the post has been filled and 980 new dental graduates registered last year. Out of this only 504 graduates has been given placement. The rest is still waiting for almost 6-8 months. Another 1000 graduates will join the rank this year! While I agree that we still need more dentist in this country, poor planning has yet again messed up the situation. While the DG has said that 391 new post will be created this year, would that be enough to absorb everyone? Interestingly, they are also creating 300 contract post. Does this mean that some will be given dental internship on contract and then need to reapply for civil service? Since the compulsory service is only 1 year, the government is not obliged to provide you with a job. How the selection of permanent and contract will be made? It looks like MOH has to become the dumping ground for all the “grandiose” plans of our education ministry in the name of education hub!

ON another news, our Deputy Health Minister has said that they are discussing with JPA to create more MO post to achieve the magic doctor: population ratio of 1: 400. I simply don’t understand the obsession with numbers by our government. How many post can the government create in a year? WE are graduating close to 4000-6000 students every year from now onwards. Would the government be able to create 4000 post every year? From the statement by the deputy minister, it is clear that we are running short of MO post. I heard him talking in the news and he clearly said that it is new MO post that will be created but the news portal reported as housemanship. Housemanship is a rolling post and the number of post in each hospital depends on the number of consultants and number of beds. You can’t simply create HO post as you like. So, what happens after you achieve the ratio? I expect this to happen by 2018 and not 2020 as projected. I just hope that MMC would not succumb to pressure of reducing the compulsory service, as for dentist and pharmacist!

Today our DG made another press statement regarding the housemanship situation. While most of what he said is nothing new except for approving military hospitals as training hospitals from 2017, the last paragraph interested me. It looks like MOH is mooting an idea where the excellent HOs will be given a choice to choose their field of interest as a MO. From what I understand from the statement, this will prevent them from going to district or rural posting and remain in the hospital for their further training. This in turn will shorten their postgraduate training. While we have to wait for proper circular on this, I don’t feel comfortable with the idea. Does this mean, the ones that go to rural and district postings are second class doctors? I had always felt that doing district and rural postings is a good experience. It teaches you a lot in terms of surviving with minimal resources, taking responsibility and learning the socioeconomic situation of people. How the assessment and selection will be done? Will we be creating more apple polishers? Will there be an exit exam? I heard rumours that those who passed MRCP, MRCS Part 1 etc will be given preference. Would there even be a guaranteed job after housemanship in near future when the ratio has been achieved?

Well, we just have to wait and see. Our DG is also working hard to create alternative pathway for specialisation by working with Royal Colleges in UK and Ireland to accreditate training centres in Malaysia. Hopefully it will create more pathways in doing postgraduate training.

Kenyataan Akhbar KPK 6 Mac 2016: Isu Nasib Graduan Bidang Pergigian yang Terpaksa Menunggu Hampir Setahun untuk Penempatan Khidmat Wajib di Hospital Kerajaan

Posted on March 6, 2016 by DG of Health

Pada 4 dan 5 Mac 2016, Buletin Utama TV3 telah melaporkan mengenai nasib graduan bidang pergigian yang terpaksa menunggu hampir setahun untuk penempatan khidmat wajib di hospital kerajaan.

Kementerian Kesihatan Malaysia (KKM) sedia maklum dan sangat prihatin di atas isu penempatan graduan pergigian baru. Pada ketika ini, terdapat kekangan perjawatan kosong bagi Pegawai Pergigian di KKM kerana jawatan yang sedia ada hampir keseluruhannya (99%) telah diisi. Seramai 980 graduan telah mendaftar dengan Majlis Pergigian Malaysia pada tahun 2015 dan jumlah ini menunjukkan peningkatan yang amat ketara berbanding dengan tahun-tahun sebelumnya. Daripada jumlah ini, seramai 504 graduan telah mendapat penempatan di KKM. Baki sebanyak 476 telah menunggu selama 6 – 9 bulan dan masih belum mendapat penempatan memandangkan hanya 87 perjawatan kosong untuk diisi. Tambahan pula, kadar atrisi (attrition rate) Pegawai Pergigian pada 2015 adalah hanya lapan peratus (8%).

Peningkatan jumlah graduan ini sebahagian besarnya disumbangkan oleh jumlah graduan luar negara yang telah menunjukkan peningkatan hampir dua kali ganda sejak tahun 2014 (2013: 245 orang; 2014: 447 orang; 2015: 482 orang). Namun, peningkatan ini bukanlah bermakna terdapat lambakan graduan pergigian. Berdasarkan unjuran keperluan Pegawai Pergigian oleh KKM, negara masih memerlukan Pegawai Pergigian. Dengan mengambil kira pertambahan penduduk, jangkaan bilangan graduan dan bilangan atrisi, nisbah Pengamal Pergigian kepada penduduk semasa iaitu 1: 3,000 hanya akan tercapai pada tahun 2018. Selaras dengan itu, pembangunan dan perkembangan fasiliti di KKM juga akan dikaji semula supaya tidak menjejaskan perancangan penempatan graduan pergigian untuk khidmat wajib.

Keperluan khidmat wajib di sektor awam bagi graduan pergigian adalah seperti yang terkandung di dalam Akta Pergigian 1971. Perkhidmatan awam ini merangkumi Kementerian Kesihatan Malaysia, Kementerian Pengajian Tinggi dan Kementerian Pertahanan. Pada masa ini, majoriti (95%) menjalani khidmat wajib di KKM. Khidmat wajib pada dasarnya dilaksanakan supaya bilangan Pegawai Pergigian di perkhidmatan awam mencukupi bagi meningkatkan aksesibiliti perkhidmatan pergigian kepada Rakyat. Selaras dengan perkembangan semasa dan setelah mengambil kira pengeluaran graduan pergigian dari pelbagai universiti dalam dan luar negara, khidmat wajib ini juga dapat memastikan graduan dapat menyesuaikan diri dengan sistem kesihatan negara.

Beberapa pendekatan telah diambil bagi menangani masalah penempatan ini:

  • Pengurangan tempoh khidmat wajib

Khidmat wajib telah bemula pada tahun 2001. Pada masa itu tempoh khidmat wajib adalah selama tiga tahun. Dengan peningkatan bilangan Pegawai Pergigian, tempoh khidmat wajib telah dikurangkan ke dua tahun pada 5hb April 2012 dan seterusnya kepada satu tahun pada 1 Julai 2015. Pengurangan tempoh khidmat wajib akan memberi peluang kepada Pegawai Pergigian untuk berkhidmat di sektor swasta dalam tempoh yang lebih singkat.

  • Penamatan Pegawai Pergigian kontrak bukan warganegara dan pesara

Sejak tahun 2012, panduan lantikan pegawai kontrak di KKM telah dikaji semula di mana KKM telah menamatkan lantikan Pegawai Pergigian kontrak bukan warganegara dan pesara. Langkah ini memberi laluan pekerjaan kepada graduan baru.

  • Moratorium Program Pergigian

Mulai 1 Mac 2013, Moratorium Program Pergigian telah dikuatkuasa selama tempoh 5 tahun sehingga 2018. Salah satu syarat yang terkandung dalam moratorium adalah menghadkan jumlah pengambilan pelajar tempatan kepada 800 setahun.

  • Pewujudan jawatan baharu bagi Pegawai Pergigian

Mengambilkira keperluan dan ekspektasi rakyat terhadap perkhidmatan kesihatan pergigian yang semakin meningkat serta pembangunan fasiliti kesihatan yang dinamik, jawatan Pegawai Pergigian baru diwujudkan secara berfasa. Pada tahun ini, sebanyak 391 jawatan pada gred U41 baru dan 300 jawatan kontrak bagi warganegara telah diwujudkan bagi menempatkan baki graduan pergigian tahun 2015 yang belum dilantik. Permohonan jawatan tambahan Pegawai Pergigian akan dibuat secara berperingkat untuk graduan 2016 dan berikutnya.

  • Memperhalusi kaedah-kaedah lain

Beberapa perbincangan telah dan akan diadakan dengan pelbagai pihak berkepentingan (stakeholders) termasuk pihak swasta bagi mengkaji kaedah-kaedah lain bagi mengatasi isu penempatan Pegawai Pergigian. Kaedah-kaedah penempatan graduan pergigian akan diperhalusi dengan lebih terperinci sebelum sebarang keputusan muktamad dicapai.

Sekian, terima kasih

DATUK DR. NOOR HISHAM ABDULLAH

KETUA PENGARAH KESIHATAN MALAYSIA

6 MAC 2016

Press Statement DG of Health 9 March 2016: Strengthening The Housemanship Training Programme

Posted on March 9, 2016 by DG of Health

The Ministry of Health (MOH) takes note of the concern of various parties involved on the issues and challenges related to the Housemanship Training Programme. Hence, MOH wishes to reassure the public and the healthcare professionals alike that there have been continuous efforts to transform and further enhance the training programme.

Numerous discussions and engagements have been made with various stakeholders from the Housemanship Training Hospitals, top MOH management, and relevant specialists; including engagements with the Ministry’s Clinical Specialists during the Specialists’ Conferences in Malacca (2013) and Port Dickson (2015). Various inputs were also sought from the Malaysian Medical Council (MMC) and Malaysian Medical Association (MMA).

To ensure adequate clinical exposure and good quality of training, the number of public hospitals that offer housemanship training have also been increased from 38 hospitals in 2009 to 44 hospitals in 2015. Several other hospitals will be accredited as Housemanship Training Hospitals in the near future, including Shah Alam Hospital and Langkawi Hospital. Likewise, Royal Military Hospitals were approved for accreditation and will begin accepting House Officers (HOs) from the year 2017.

To enhance their clinical skills, from 2008 the period of the housemanship training has been extended from one year to two years. Prior to 2008, HOs had to only undergo three major disciplines postings but this was improvised to encompass six major disciplines namely Internal Medicine, Paediatrics, Surgery, Obstetrics and Gynaecology, Orthopaedics and Emergency Medicine. To further increase the training opportunities without compromising the quality of training, three alternative postings were also introduced i.e. Anaesthesiology (2010), Primary Care (2013) and Psychiatry posting (2013); thus increasing the number of disciplines from six to nine postings while maintaining the two-year duration of training.

To further strengthen clinical supervision and assessment of HOs, Housemanship Training Committees were established at the hospital level in the relevant clinical departments, and at the State Health Department level. Efforts were also made to improvise the log book to record HO’s clinical encounters and experiences throughout their training in each discipline.

To ensure HOs receive adequate exposure in these postings while improving the working hours’ system for HO, the Flexi Working System was introduced in 2011. The training programme was reviewed further to ensure the HOs will have greater accountability and ownership of their patients. This was done through the introduction of the Modified Flexi System in 2013 where thereon HOs are expected to work 65-75 hours per week and will have adequate training exposure including in Wards, Clinics and Operation Theatres. This system will be continuously monitored and efforts will be made to improve it further from time to time.

To further improve the efficiency of HOs intake into the Housemanship Training Programme, the Public Service Commission have organised the appointment into public service to be done every two months, depending on the vacancy of posts. Since March 2015, MOH has introduced the ‘e-Houseman’ system by which the medical graduates themselves can choose via an online portal, the hospital where they wish to be posted for their housemanship training, subject to vacancy of posts. There will be a shorter waiting period for those who choose to undergo their housemanship training outside of Klang Valley, especially in the more remote hospitals that often have more vacancies. In contrast, medical graduates wishing to be placed in hospitals in bigger cities, with less post vacancies, will most likely have to wait longer.

To assist the HOs in understanding their work better, since 1stSeptember 2014, the HO induction course has been extended from a one-week programme to two weeks. The first week of the induction programme introduces HOs to the expectations of civil servants, integrity, ethics and Medical Acts and various others service issues. The second week involves clinical orientation conducted at each respective Housemanship Training Hospitals.

Moving forwards, the MOH is mooting a fast-track system to shorten the duration of training for HOs who excel in their training, whereby these brilliant HOs will have the possibility of a speedier promotion to become Medical Officers in their chosen field, and subsequently be able to pursue their postgraduate training to become specialists in a shorter duration.

Thank you

DATUK DR. NOOR HISHAM ABDULLAH

DIRECTOR-GENERAL OF HEALTH MALAYSIA

9 MARCH 2016

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In October 2015, I wrote regarding the crisis that was blooming in UK healthcare system. While negotiation was going on between BMA and the government of UK, it seem to have headed no-where. In January 2016, the junior doctors had their first strike since 1975 to go against the proposed change in contract and definition of working hours. On 15th January, the Health Secretary released statistics on the number of deaths during weekends to justify the change in the contract. Remember, this is exactly what I said the politicians will do in my October 2015 article. Once they prove to the public the statistics, they will get public support. Unfortunately, despite the strike, the government stuck to their plan. Another strike took place early this month. It looks like the government of England will go ahead with their plan soon. So, graduates who think grass is greener on the other side should always think carefully. Being a doctor is always stressful no matter where you are. The only difference is the healthcare structure, facilities and training.

There is also another issue that is being discussed aggressively in the UK. It is the change of migration policy. The UK Migrations Advisory Committee had suggested that UK trained international doctors, of which there are around 500 each year, could be subject to the Resident Labour Market Test (RLMT) when moving from the second year of foundation training to specialty training. Previously doctors were exempted from RLMT. You can view the document here: bmj.i1008.full.

I received an interesting email from a Malaysian doctor in UK who is intending to come back home. He had given permission to publish part of his email below.

I am not sure if you are aware but staying in the UK post-FY2 (i.e. housemanship) will not be as easy. Being subjected to the Resident Labour Market means that:

1. International med students graduating from the UK are only allowed to apply for Round 2 of specialty application
2. This means being left with jobs that NO one wants. Popular research spots like London, Oxford and Bristol would be out of the picture.
3. Popular specialties like neurosurgery, cardiothorasics, anaesthesia and paediatrics will not be accessible, based on last years outcome (as there were no round 2 interviews for them).
4. This becomes worst when applying for advanced specialty training (ST3 onwards)… core Medical trainees will be left with geriatrics or acute medicine, and not be given the opportunity to try research heavy specialties like rheum or cardiology.
Just thought I’d illustrate the current climate with the forced implementation of junior doctor contracts – International Doctors are not only forced to obey the contract but all other new laws implemented, including the above.
There really is no more space for doctors in this world. sad times.”

As I had always said, doing medicine with the intention to migrate is the worst thing to do. However, even my suggestion to do medicine in the country you intend to migrate is also falling apart. Meanwhile, in the US, by 2023, the rules for ECFMG certification will also change. This change was already suggested in 2010. At the moment, as long as your medical school is listed in World Directory of Medical Schools (WDOMS), you are eligible to sit for USMLE and receive ECFMG certificate for your Step 3 and residency application. However, WDOMS only list the medical schools which has been approved by the authority in a respective country to conduct a medical program. It does not give any form of recognition, accreditation or assessment regarding the medical schools listed. Basically, it only states that such a university is offering a medical program in such a country. The programs do not even need to be accredited by the respective country’s medical council.

With the new change, by 2023, the respective country’s medical council should apply to ECFMG to be accredited as a accreditation body. This basically means, Malaysian Medical Council must first apply to ECFMG to be recognised as a accreditating medical authority. Only then, medical schools accredited by MMC will be allowed to apply for ECFMG certificate. So, if MMC do not do this, no one who graduates from Malaysian medical school will be able to apply for a residency job in the US. Of course, this boils down to each country’s medical council’s ego. Why should MMC do this if it is going to worsen brain drain? I mean, would you do something to send your workforce out of this country? So, those who are entering medical school now with the intention to go to US, please beware that this may affect you as you will be graduating somewhere after 2021.
So, I had spoken about Australia, UK and now US. The saying that ” doctors will never be unemployed“, ” doctors are needed everywhere” or “doctors never get retrenched” is becoming a fallacy.  Unfortunately, there are still a lot of ignorant parents out there………. However, I am hearing some news that the enrollment into medical schools is dropping in Malaysia and some of the smaller medical schools may need to close shop eventually.
Hopefully, my book that may be launched next month/April will be read by all parents and future budding doctors. Keep a watch as the details are revealed soon………..

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