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Since our new DG took over the Ministry of Health, there seem to be a lot of changes that are taking place. In my last post https://pagalavan.com/2012/05/31/for-future-doctors-recognised-specialist-degrees-and-period-of-training/, I mentioned about the new rules that are being implemented for those who are planning to sit for MRCP or MRCPCH. You need to have at least 4 years of training before even going for the gazettement process.

In March 2012, I wrote this https://pagalavan.com/2012/03/07/for-future-doctors-the-storm-is-coming-part-2/ where the new rule says that you can only apply for subspeciality training 2 years after you are gazetted as a specialist. AND during this 2 years, it is compulsory for you to serve rural areas for a minimum of 6 months, mainly in Sabah and Sarawak https://pagalavan.com/2012/02/08/for-future-doctors-panduan-penempatan-dan-pertukaran/.

There was one thing that I did not mention in all these postings : the bond with the government. I am sure everyone knows that all JPA scholars are bonded for 10 years. Almost all local university graduates are JPA scholars as it is offered to all of them. If you do Master’s, an additional bond of about 5-7 years is added depending whether you are doing under open or closed system. Since last year(2011), another new bond has been created for subspeciality training. Every subspeciality training except for cardiothoracic, urology etc is about 3 years. You are required to do 2 years locally and another 1 year overseas or at another centre locally. I was informed that the additional bond is 3 years for the 2 years local training and another 3 years if you go overseas under MOH, a total of 6 years.

Remember that these bonds do not run concurrently but one after another. So, the total number of years bonded will be 21-23 years with the government( if you are an undergraduate JPA scholar). This has created a lot of unhappiness among the doctors in Ministry of Health. Many feel that there is no point doing subspeciality now as they are already sitting at the highest salary grade of U54 and nothing to look forward in terms of salary increment. JUSA post is very much limited. I had written about this in MMA magazine in 2011 here : https://pagalavan.com/my-mma-articles/march-2011-the-great-transformation-revenge-of-the-fallen-to-the-dark-of-the-moon/.

So, with the salary being at the highest grade of U54( with RM300 annual increment for max 10 years), who wants to take another 6 years of bonding for doing subspeciality with no additional benefit? I was informed that many who wanted to go to private are already leaving the service without a plan for subspeciality ( about 100 specialist left MOH last year!). Only those who are genuinely interested in doing subspeciality for their own interest are staying on. I expected this to happen when I wrote the above article in MMA in March 2011. Again, what I said is coming true.

There are also many with MRCP or MRCPCH who are going to Singapore and IJN for a shorter route of subspeciality training. BUT a word of caution for junior doctors: the private sector is getting saturated as well in major towns and the soon to be introduced 1Care system may merge public and private healthcare in the country in near future. So, there will come a time where the income earned by private doctors may not be much difference with public doctors.

Till then, enjoy the bureaucracy in civil service, the reason I left!