Why did I choose Rheumatology as my subspeciality?
I was a General Physician for almost 4 years before I decided to do my subspeciality. My interest has always been in general medicine but unfortunately, the trend now is for everyone to go for subspeciality training for better prospects in the future.
I chose rheumatology as it fascinates me. It is the only subspeciality that looks at a person as a person! We don’t look at any particular organs but everything. Rheumatological diseases are systemic diseases that are multi-organ in nature. Even though I hated immunology as a medical student but rheumatology really excites me.
In this page I may add important informations about the field of Rheumatology and abstracts of my publications in local and international journals.
This page has the following sub pages.
- My Publications
- 1st SLE Public Forum in Johor
- What is SLE?
- Systemic Lupus Erythematosus (SLE): A Guide for Patients
- The Kidney in SLE
- Pregnancy in SLE
- Rheumatoid Arthritis
- Medications for Rheumatoid Arthritis
- Gout
- Psoriatic Arthritis
- Scleroderma/Systemic Sclerosis
- Ankylosing Spondylitis
- Juvenile Idiopathic Arthritis
- 2nd SLE Public Forum in Johor
- Severe Rheumatoid Arthritis of Hip Joint
- Johor Rheumatology Update 2011 : 23/10/2011
- SLE Public Forum 2012 Johor
- Johor SLE Public Forum 04/03/2012
Pagalavan's Avatar 
Oh yes…i would agree with u that rheumatology involves seeing the person as a whole. Sometimes, i wonder why the learning of other organ when i cant applied when become specialist. At least, being rheumatologist allowed myself not to waste of information that i have learn so far.
Would u mind share with me pro n cons being rheumatologist n how it is different with other sub speciality
AS I said above, rheumatological diseases are multiorgan in nature as thus we have to look at the person as a whole. A cardiologist for an example, does wonders by clearing vessel blockages etc but forgets about the control of diabetes! Same goes for a nephrologist who manages lupus nephritis. He only looks at the kidneys and forgets about the rest of the manifestations of lupus!
website looks great!! well done.
Leow
how did you reach my blog? how’s life ?
Pagal
dear dr,
i always follow ur article in MMA magazine, but today only i gt to knw rgrd ur blog. its really informative blog. i finished my hsemanship dis may, n doing mo in health clinic. was in med dept in hosp kangar then they sent me to kk. im really interested in med as well as rheumatology…hope can get some guidance and input fr dr. im MMA life member, n exco for perlis state mma oso. thank you dr
If you are interested in Internal Medicine, I would suggest you to do MRCP rather than Masters as it is recognised internationally unlike masters. After completing your MRCP and 18 months gazettment, then you can apply for Rheumatology!
Again, you have a long way to go.
Could you shed some insights on link between HLA-B27 antigen and Rheumatogy.
HLA B27 is associated with seronegative spondyloarthropathies like ankylosing spondylitis, reactive arthritis etc.
thank you for ur input dr…
Dear Doctor,
Recently, when i got up in the morning, i felt stiffness in my body especially in my abdomen.I felt difficult to bend my body. and that would last for about ten minutes. After some stretching, then it would be ok. Please help… Is there any underlying problem? Thanks and sorry to trouble you.
Very difficult for me to say anything as there could be many reasons for this symptom. One have to see and examine you before deciding what is wrong.
You need to see a doctor!
Dear Dr.Pagalavan,
I happened to come across your blog by chance and am very taken up to know that Columbia Asia has a Rheumatologist on board.
For your info, I am the Medical Records Manager at Columbia Asia, Seremban.
Actually, I am writing to you to find out if you have any info on Fibromyalgia. I am a Fibromyalgia patient for the past 4 years and am interested to know if you know of any treatment which can be helpful in relieving the pain other than Lyrica!
Is there by any chance of any Fibromyalgia specialist in this region whom I could go for treatment?
I hope I am not troubling you too much. Hope to hear from you soon.
Thank You & Regards,
Rathi
Lyrica is the latest therapy for Fibromyalgia. However, sometimes it may not work or the dosage may not be adequate. Unfortunately it is expensive. The other options will be Gabapentin or opiates.
There is no Fibromyalgia specialist in Malaysia. It is a difficult disease to treat.
Hello doctor, I came upon your site while searching for fibromyalgia malaysia. I have been seeing doctor Raveendran from sdmc since beginning of the year now in regards to my fibromyalgia condition..he has been quite helpful to help me understand my condition.
You wrote that in 2010. I am wondering if you would know of any updates in fibromyalgia in malaysia?
There are not much updates in Fibromyalgia. Dr Ravee will know the latest. Lyrica was the only drug that was officially approved for fibromyalgia
Dear Dr Pagalvaran,
Could you shed some insights on ” Atypical p-ANCA” blood test result? Is there a link betwwen atypical p-anca and vasculitis? Could a normal healthy person also get Atypical p-ANCA” blood test result?
Is the titre of ANA correlate to the severity of symptoms of an autoimmune disease?
Why is ANA can be negative even if during flares up?
If one suspect to have an autoimmune disease, which is at present not classifiable under the usual criteria, but doctor starts to treat with hydroxychloroquine and prednisolone, is there any long term side effect?
I am impressed as you chose to study rheumatology as It is the only subspeciality that looks at a person as a person! But I read from the website that when the autoimmune diasease “attacks” other organs, one would see a few specialist at the same time.
Thank you very much for your help. Your help is greatly appreciated.
Atypical p ANCA is rather non specific, it can occur in many conditions including infection. Try MPO and PR3 ANCA.
ANA may or may not correlate with disease severity. Usually, we don’t use the ANA titre as a marker of flare. We go on clinical signs and symptoms.
In undifferentiated autoimmune disease, the treatment depends on what are your menifestations. Prednisolone obviously has a lot of long term side effects but hydroxychloroquine is relatively safe.
A rheumatologist usually manages a pt as a primary doctor. Other specialities may be involved depending what organ is affected etc. BUT we see the patient as a person and not by any individual oragans.
Dear Dr Pagalavan,
Thank you for the answer. is there any lab in Johor can provide MPO and PR3 ANCA blood test? If the autoimmune disease is in remission, isn’t the test for MPO and PR3 ANCA will be negative, therefore it won’t help in diagnosis?
If it is undifferentiated autoimmune disease, i.e. it is not a “true” autoimmune disease, can one ignore taking hydroxychloroquine and prednisolone, just take NSAIDs when there is joint pain, apply Triamcinolone Acetonide oral paste when there is mouth ulcer, take pcm when there is fever?
Your professional view is greatly appreciated.
Gribbles lab can do MPO and PR3 ANCA. sometimes the antibodies may still be positive even when you are in remission.
I would rather suggest to stop pred and con’t hydroxychloroquine. Hydroxychloroquine has been shown to reduce the number of flares in many autoimmune diseases.
Dear Dr Pagalavan,Could I know if there is any Rheumatologist in JB government hospital?If Rheumatoild Factor is negative, can one conirm that it is not rheumatoid arithritis? May I consult you that what could be the reason of the swollen, painful of both ankles and wrists with the following blood test result? TWBC:12,000; Polyporphs:88%, Lymphocytes:10%; ESR:60; C Reactive Protein:120 mg/L; Platelet: 453,000; Hb:8.5. If the TWBC is highhow could tell the different between infection and inflammation?Thank you very much for your help and advice.
There is 1 Rheumatologist at Hospital Sultan Ismail. Your features do look like Rheumatoid Arthritis but we need to look at you to confirm the diagnosis as there are many diseases that can present similarly
Thank you Dr Pagalavan. May I know how could one get refer to the Rheumatologist at Hospital Sultan Ismail as the blood test and medical fees, and medicines at private hospital is quite expensive?Your help is much appreciated.
Go to any nearest gov polyclinics and get referral
dear doc… we have met before but doubt if u still remember…with dr ralph.
well i’m now a gp in rawang (with a group practice) . i would consider myself fortunate as when i was in med school i had a very dedicated physician/rheumatologist dr anurag bharadwaj as my lecturer. in the past few months i have come across abt 3 cases of juvenile ra and 2 cases of sle. i’m glad i was able to pick it up fast enough. i would appreaciate if u could include a session in your blog on how gps can monitor and treat certain rheumatology cases . this may help to reduce or at least help the patients in view of waiting time at public hoispitals. than ks
I think it is mentioned in my blog postings. unfortunately in rheumatology, every individual is different and the treatment and monitoring varies with each patient. In fact, rheumatology is probably the only field where the same doctor need to see the patient on each visit, ideally.
Hi Paga….
Nicely written articles….. and it’s nice to read something about medical again
Haha, fakhrul where are you now? I wonder how you found my blog?
Im in KL…. I was looking thru pictures in my friend’s fb when i saw a photo of lousy referral letter with footnote mentioned ‘taken with consent from pagalavan.com’…..Hey! I know this guy from my previous life…haha!
Haha, are you still practising or doing business?
Hi Dr Pagalavan,
Very nice blog. I like it. 🙂 Keep it up.
The last patient I saw was 5 years ago…haha…and that was in HSA…Im doing business now, anyway I knew you were in Monash as I was doing Case-mix project with Prof AZ & Dr Sivalal…..eh you’re going to the immuno conferance in Singapore this coming Nov?
nope, no time in private hospital now. I am sure you are doing well with your business.
hi dr pagal..im just finished my study doing medicine..now must go for HO..i have to choose 3 hosps..if u dont mind would u recommend any 3 hosp which are good for HO training…i live in selangor..i also jpa scholar n after finish my HO i want to be a surgeon ..can u suggest what its good for me..MRCS or doing master or what…tq before..
Please read all my other posts in this blog. From what I gather, the HO post for selangor is full and your chances are slim if you apply for Selangor. Even if you do get a place in Selangor, you will be transferred out of the state after completing your housemanship. The glut is getting worst. You can choose any of the big hospitals like Klang , HKL, Kajang etc. MRCS is NOT a surgical degree. The only way to become a surgeon in Malaysia is via Masters.
Hye chitappa, I am Tharshen Balachandren here.Can i know how to apply for any Medical Universities after SPM?Which is the best Medical University in Malaysia, and the requirements that I need in SPM to be a successfull Doctor like you….thank you
Best Regards,
THARSHEN BALACHANDREN
HARSHINI BALACHANDREN
SPM is not suppose to be the entry qualification for medicine. You need a good grade(at least 4 or 5As) in a well recognised pre-U exam such as STPM, A Levels etc and not some dubious foundation programme.
Good Unis in Malaysia: UM, UKM, USM, IMU and probably PMC and Monash. Pls ask the respective Unis of how to apply.
Thank you chitappa.
Dear Dr. Pagalavan,
Good Day to you and I hope you are doing well. I have been diagnosed with RA for 5 years now and have only been seeing one doctor ( out of respect, I will not mention the name here). Recently, after an x-ray of my right wrist, it has been confirmed that it is clinically damaged. Having said that, and prior to this outcome, my other half has been pushing me to see another Rheumatologist as he feels that my Rheumy seems to be doing me no good. I have tried to explain to him that every patients body reacts differently to meds and it can be a trial and error matter when it comes to diagnoses like RA. So, long story short, I’d like to seek your advice on who else can I consult with (I’d like to consult with you BUT you are in Johor and I’m in Selangor) on this matter just to not complicate matters plus I figure, it would not hurt me anymore than it already has to do so. I’ve looked into the matter of a total wrist implant. However, apparently it has not even been heard of here and IF it has, it probly is still only on paper. I know that in Singapore only ONE patient has done the surgery. It has been stated that most patients rather “live” with their condition or do a partial or total “LOCK”, due to the total joint replacement surgery being very expensive. It was cited that it could be as expensive as SGD20K. Now, with my condition, what further advice may I acquire from your kind self and again, will you be so kind as to recommend me other Rheumatologists I may consult with in PJ/Selangor. I thank you very much for your patience and time. -Alicia-
I am not sure what is really happening here. Probably the damage was already there before you started on treatment? You need to talk to your consultant regarding the issue. Wrist replacement surgery is rarely done as the outcome is poor. mostly, we will do wrist fusion surgery.
No, Doc. No damage to this extent at that point of time. Actually, will e-mail you what I have been on before. As the disease progresses, and so does my age(I’m 37 this year), I’ve been taken off all meds to allow me to try for a child. Will update you via e-mail soon. Thank you for your time.
Hai, Dr. Reading sentence above, you hated immunology, how do you score your immunology since it is quite tough to get good grade with it???
I am a clinician and not an immunologist
Sir,i m a undergraduate student from matriculation.recently, i got offer for medicine from UKM and UPM. which one would you suggest ?
Both are OK but I would prefer UKM.
Thank you sir.
Dr, any recommended book for rheumatology to read ?? Thank you.
For undergraduate or post graduate?
both….thank you…
Try oxford rheumatology ( they do have a handbook as well), Rheumatology secrets etc
Rheumatology is an awesome subject to learn..hope that Dr you can share with us your experience in rheumatology……Thank you….
Dear Dr Pagalavan,
I stumbled upon your blogsite quite by chance. I like your spirit and hope you will take some time to check out the work of Prof.Dr Ananthan Krishnan ( if you are not already familiar with his work) in many areas of disease and healing @ http://www.amriasia.org. The rest I leave it up to you. Have a great life.
Best regards,
Asha Ravindran
hi Dr Pagalavan,
i too came across ur blog by chance and it is indeed a good read. keep it up Dr!
i guess the Lady Luck was smiling on me to came across your blog today. we are in a tight position and your opinion would truly be appreciated. but before that, let me introduce myself. i am an Outpatient Pharmacist in a district hospital in Sabah.
i am not sure if you are aware, but there is a nationwide shortage of Tab Methotrexate. many facilities have run out of stock and unable to replenish it as the generic company has ceased production, while the original brand is unable to cope up with supply. my facility is one of it. we have asked from other hospitals but none are able to borrow us any supply either
inevitably facilities need to consider alternatives for the time being till some miraculous solution is found. i would like to ask your opinion on converting the tab Mtx patients to either IV MTX or Tab Sulphasalazine. can we do it temporarily? is there any dosing guide which you follow for reference? or is it fine to let patient to be MTX free till the supply arrives (which may be very long). we will me discussing this with our doctors tomorrow, but your input will be very helpful.
thanks, and have a good day ahead!
Thanks for the comment. YES, I am aware of the MTX shortage. I am facing the same problem here.
SC MTX (not IV)can be used as an alternative but not SSZ. SSZ takes a long time to work and not equivalent to MTX.
PFizer claim that they will try to get the stock by next month. I got no idea how we ended up with this problem as MTX is a very old drug. I am sure there are many generic companies in India who can supply us.
thanks a lot for the speedy reply Dr. so based on several studies, they are recommending a 1:1 dose conversion from Tab to SC MTX. and if the dose is above 15 mg, the papers suggest to use SC MTX 15mg first before further consideration of dose increase. is it fine if we suggest this?
and how about lab investigations? should we recommend lab investigation first before the SC treatment are started to monitor for side effects? we did came across some patients whom had their liver profile deteriorating after a single SC MTX dose.
Yes, 1:1 dose is OK. LIver function must be monitored more closely as the bioavailability is higher for SC.
Good day Dr.
Please, I have to ask your help if this is possible, I need to finish me PhD in rheumatology in malizia how you can guide me please,
Thank you so much
Helo dr! Well, I am going to do medicine degree next year! And I m so excited and passionate about this! I would like to ask for Ur suggestion on which uni and medicine pathway that I can go for~I have no idea in choosing which uni should I go for in Malaysia, hope to hear from u! Thanks^^
Hello Dr, just have some doubts that need to be clarified..
Should patients with osteoarthritis or rheumatoid arthritis also suffering from chronic cardiac failure benefit by receiving a coxib ?
Does the coadministration of aspirin (acetylsalicylic acid) with a coxib mitigate its cardiovascular risk?
Thanks
All NSAIDs has been shown to increase CV risk if taken long term. adding of aspirin actually reduces the incidence of MI.
Thanks for the information. I am currently in form 3 and wish to proceed my study in medical course once i enter university. Can i know either than pharmacist are there any career that has a high job opportunities in the future? Thanks
Hai Dr. I am a medical student just entering clinical year. I have some confusion regarding history taking. Why are we asking review of other system??? The complaints should be related or non related to the history of presenting illness??? If it is related, then it should be under HOPI instead of other system, if it is not related, why are we asking for review of other system??
Because patients do not necessarily only have one problem, and many diseases are interrelated.
The system review is to make sure you do not miss anything important that the patient might not tell you. Once you get good at history taking, system review can be done while you are taking HOPI.
Tq Dr for answering my question. May I ask as a medical student, any tips to master all those common disease?? they seems to be so much to be remember. even clerking a few same cases does not improve much for history taking and sometimes cant answer basic questions.
That’s why medicine is life long learning! you learn till you stop practicing!
That is also why only the best are selected to do medicine all over the world, except in Malaysia where every Tom, Dick and Harry can do medicine.
Dear Doctor,
I am Suganthi from Ipoh, Perak. My mother is suffering from Rheumatoid Arthritis for the past 10 years. She is in pain killers everyday. Is there any chances for us to visit you and get your advise? Or is there any specialist doctors that you can suggest to us to follow up with them?
Hi dr,
I am interested in doing rheumatology as I find some of the diseases quite fascinating.
Fyi, i have just finished HOship and is starting MOship soon.
Is rheumatology a good career for women doctors ( in terms of life-work balance)? How frequent are the oncalls? How busy does the work gets?
If u dun mind (n if u r free) mind telling us how it is in a day’s life of a rheumatologist?
Thank you!
In government service or in private sector, you will function as a general physician as well. You will never work as only a rheumatologist. Thus the working life is the same as any other physician.
Why one will never work only as rheumatologist, dr Paga? I thought it’s already a big specialization that a doctor can focus only on that department.
In private, you can’t survive by just doing your subspeciality! Your income will be the same as a government servant
Hi Doctor!
I feel that I may have the symptoms for Fibromyalgia. For years I have been in sorriness and pain and nothing has seemed to solved it until I searched for “Fibromyalgia”.
I am currently staying in Kuala Lumpur, and would like to consult a doctor. Which doctor would you recommend? Any advice would be appreciated!
Thank you!
You can try Dr Ravi at SJMC or UMMC consultant rheumatologist
* soreness, and nothing has seem to solve or make it go away”
Hi Doctor.
I am 19 years old and diagnosed with RA since 2012. I would like to know if a RA patient will be allowed to take up medicine and become a doctor? Do I need to reveal this condition during my medical check up?
It all depends on how bad is your disease and complication that has occurred. Generally, as long as you can function , it should not be a problem.
YES, you need to reveal all your illnesses.
Dear Dr Pagalavan, Sir please advise , can a hospital take disiplinary action such as extending the job posting by another 4 months although the consultant and specialist did an assessment at the end of a job posting and was asked to move to another posting. The mistakes done were not deliberate and and incident report was made and explanation made. Can the hospital suspend the housemen ( house officer ) to undefinite time period . Please advise what need to be done.
It depends on Head of department. Usually the Pengarah will the HOD. If HOD feels that you need to be extended than he can. Report will have to be sent to MMC And MOH on the reason for extension
Dear Dr pagalavan, the actions taken by HOD if extending , will it have implications of delayed posting of to MO later .
Since your housemanship is delayed, obviously your MO posting will be delayed
HI DR, is atrodar a good drug for osteoarthritis?
I don’t use it
thks
Dear Dr Pagalavan,
I understand that all HO need to be give a day off after 6 days of work straight. However there is a dept in GH kuantan , where the HOD refuses to give even a day off for the 4 month in paed dept. is that right , what can be done ? Please advise.
It’s not 6 straight days. They calculate the hours. If I am not mistaken, it is 60 hours per week and a day off. If you are doing shift duty, then the day off may not happen.
Dear Dr Pagalavan,
I have just recently passed my MRCP (UK) while working in Penang GH. I am about to reach 3 years of MO-ship thus far and hence, I have quite some time to go before being eligible to apply for my sub-specialty training.
I am interested to do Rheumatology. While I am waiting for gazettement, is there anything which I can do to boost my chances of getting into training? I am contemplating to pursue SCE (Specialty Certificate Examinations) in Rheumatology, as offered by the RCP (UK). Will this be helpful in my future application, since training slots are rather limited? Any advice?
I am now at an important, decisive juncture of my life and I hope you can help to shed some light on this topic. Your reply will be much appreciated. Thanks.
I don’t think sitting for SCE will boost your chances but you can still sit for it for extra knowledge.
What about working and opportunities in UK? I understand that MRCP is an entrance exam and it is competitive to get into any specialty training in UK, especially being a non-EU doctor applying. Will it be extremely difficult to secure a place for Rheumatology training, say if I work there for 2-3 years and have passed SCE? I am considering options as even in Malaysia now, it is very competitive to get into training post-MRCP.
Firstly, you need to get a job in UK. Based on current immigration laws, it is almost impossible to get a job. Even if you get it, it will be a non-training post in a rural area. Then you need to wait in a Q as well, to get a training post, where citizens/PRs and EU citizens will be given preference. So, the time frame will be the same if at all you get a job there.
Hi Dr Pagalavan, is there any info with regards to Muscle Inflammation Disease?
you can visit arthritic foundation website
Hi, Dr Pagalavan….
I am a foreigner here in Malaysia.
You mentioned that after passig MRCP, we have to do 18 months gazettment…
which hospital in KL can we apply to for gazettment? and is the gazettment in General Medicine ward only?
plus, by passing MRCP… Do u mean MRCP part 1 , 2 and PACES .. all?
Are you employed in Malaysia now?
No
No
Dear sir,
after a salmonella infection my joints and muscles started to ache and I had colitis yet all my blood test are always normal. My gastro specialist seem to think I have chronic reactive arthitis and sent me to a rhuemy. Sad thing is my rheumy seems to think that that there is no such a thing as chronic reactive arthitis and I am left in pain until a mri can prove inflammation .An mri will be done end of the year . I have already endured this pain for a year.
I did manage to see a private rhuemy that confirmed inflammation through his scan machine and treated me with iv steroids and I was good for about two months. But I couldnt not continue to see him due to financial restrains .
What should I do and who should I see?
Thank you.
I can’t decide for you but you can go back to see any private rheumatologist.
Hi Dr Pagalavan
I wish to enquire what is the route for specialty training in the field of ophthalmalogy in Malaysia. Is there MRCS training in Malaysia in this specialty? Do Msia doctors need to travel to Singopore/UK to do there surgical training?
Does the same apply to Rheumatology?
Dear Dr.
Rheumatology seems like an area of interest for me now.. upon completing my MRCP PACES or Masters in which hospt. could I further do my training..
you need to apply via KKM. KKM will decide which hospital
dear doctor,
can you give your address where my aunt can go for a consultation. She is Indonesian and on 3 May 2017 visited Penang Lam Wah EE Hospital for checkup and was told there is no rheumatologist in Penang. thanks.
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I am at Columbia Asia hospital iskandar puteri at JohorBahru
Hi Dr. I’m a fresh graduate and interested in psychiatry. Can you write about some information on pathway into psychiatry-speciality? Thank you v.much in advance
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At the moment the only option is Masters
Okay dr. Do you know any psychiatrist keeping a blog like this?
Not that I know
Hi Dr Pagalavan,
I would like consult you regarding medical information. I had leukocytoclastic vasculistic. This disease very disturbance in my daily life, I am Indonesian. Is there anyway I can direct have consultation with you?
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You have to come over for me to see.
Hi Dr Pagalavan,
Reading your blog and the comments above has answered many of my questions. However as some of the comments date back to a few years ago, I’d just like to clarify whether things still remain the same. I am a Malaysian currently working in the UK as a junior doctor, but I do intend to return to Malaysia after passing MRCP and apply for a specialist post in Rheumatology. So my questions are:
1) After passing MRCP in the UK, what is the next step? (I presume one needs to first apply for full registration in Malaysia, and then apply for gazettement?) What is the timescale we are looking at? Is it about 1 year wait for full registration to be approved, and another 1 year wait for a gazettement post?
2) After the 18 months of gazettement, again, how long is the wait for a specialty trainee post in Rheumatology?
3) I read that Rheumatology training in Malaysia takes 3 years (which is a relatively short period of time compared to other countries such as 4 years in the UK). What is the percentage of trainees who successfully complete the training within 3 years without extending their training?
I would really appreciate it if you could shed some light into this, as I could not find any relevant information on KKM/MOH official website. Thanks for your help!
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1) Before you get a full registration, you need to get a job in MOH. This is where there will be a huge problem for you, as currently, MOH do not have enough MO post for everyone. Without a job in MOH, you can’t do gazettement. Gazettement is 18 months with atleast 4 years internal medicine training. Your training in UK can be considered.
2) 1-2 years
3) Most do complete their training on time.
I suggest you complete your training in UK before returning
Dear Dr Pagalavan,
Thanks for your prompt reply and insightful advice. If I may, I would like to clarify just a few more things..
From what you described, were you implying that 18 months of MO job counts as gazettement? Or did you mean that after passing MRCP, I will still need to get a MO job, then apply for full registration, followed by a further 18months of gazettement? If the latter is the case, may I ask:
1) How long is the wait for an MO post?
2) How long will I have to work as an MO to be eligible for full registration?
3) How long is the wait for a gazettement post after obtaining full registration?
I apologise if some of these questions have been asked before, however I believe that it will be useful information for future junior doctors hoping to return to Malaysia.
Thanks for your help once again.
During gazettement, you are considered as a MO and occupying a MO post. Thus, you need to apply for a MO post unless they recognise your training post MRCP in UK as part of gazettement.
1) currently MO post are FULL and 50% of HO who complete housemanship by 2020 will not even get a MO post.The reason circular by MMC says that if you don’t get a MO post by 6 months, they can release you without the need for compulsory service (read some of my latest articles). Of course you may have higher chance of getting a post if you have MRCP.
2) You need your full registration even before you start your work as a MO
3) after you obtain a MO post, you need to apply for KKM to start your gazettement process. Remember that gazettement can only be done in a hospital with specialist. If your MO post is in a rural setting without specialist, that is not considered as part of a gazettement process.
Dear Sir, how can you differentiate AS from DISH please?
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Dear sir, my daughter who is 17 years old has been/is having red spots on her legs. After consulting 2 GPs, I was informed it is vasculitis. Which specialist should I see for further treatment? Please advice. Thank you.
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Dear sir, my daughter who is 17 years old has been/is having red spots on her legs. After consulting 2 GPs, I was informed it is vasculitis. Which specialist should I see for further treatment? Please advice. Thank you.
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She can see a skin specialist or a rheumatologist
Do u know any skin or rheumatologist specialist around kl and selangor whom I can see for vasculitis. Hope u can recommend one. Thank you.
Try Sunway Medical Centre or SJMC
Dear Dr Pagalavan,
Good day.
My client is diagnosed with raised Rheumatoid factor, after that he go thru Anticcp test, which reading is 0 IU/ml, and the ASOT is 200 IU/ml, and he did not encounter join or gout problem, everything is normal. Except the RF factor and ASOT.
However, he had disclosure when he was aged 20+, he was admit at hospital for 3mths due to viral infection, and the treatment given is like kidney dialysis (cuci darah, sorry I dont know how to explain in English/Malay), but after discharge he did not go thru kidney dialysis.
May I know for this case, can he visit you for further consultation? or you may refer other specialist, we are from JB.
Appreciate your prompt respond.
*** Patient is male, aged: 40 (current year), RF factor and ASOT test is done by year 2018 and AntiCCP is done by year 2014.
Thank you.
Regards,
NG
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Yes, I can have a look
Dear Dr Pagalavan,
Good day again.
I had find out more details from above client’s medical history from Hospital, he was diagnosed Rhabdomyolysis on year 2005, and seigmen to viral encephalomyelitis, and he was completed the treatment on the same year and no required any follow up visit. May I know is this the reason why his ASOT and RF factor with high reading? and in this case this client can visit you to cure his current issue?
Pls advice.
Thank you.
Regards,
NG
Hello Dr Pagalavan,
Sorry forgot to mention this client dignosed ARF 2degree to Rhabdomyolysis on the same year also (year 2005).
Thank you.
If the patient has no symptoms, there is nothing to worry about.
Hi dr.how are you?
Please come back colombia asia jb
We need you 🤗
Hi Dr Paga,
I come across your blog by chance. I was your RA patient when u were in Columbia Hospital, Bukit Indah. Hope you are good in Australia. Really miss you. You are such a great Dr to me. It is hard to find a Dr as good as like you. I have stop my consultation with any Dr on my RA after u left. I am using diet and nature healing for my RA. So far so good is under control. Meanwhile, I also try to look for a RA Dr in Johor. Any good recommendation?