Is Malaysia heading towards producing unqualified medical specialists?
SHAH ALAM - Amidst government plans to amend the Medical Act 1971 (Amendment 2012) to address the non-recognition of parallel pathway training for specialist doctors, concerns arise over whether Malaysia is veering towards producing unqualified medical specialists.
It was reported that the Malaysian Medical Council (MMC) was currently embroiled in legal actions brought by several parties.
The first case which was pending at the Federal Court was filed by Lincoln University over the regulator’s refusal to recognise its medical degree programmes.
The second lawsuit was brought by six specialists who qualified under a Universiti Sains Malaysia (USM) pathology (medical genetics) programme. They were granted leave by the court to challenge MMC’s decision not to recognise their qualifications.
The MMC was then slapped with another suit by doctors who have secured qualifications under a parallel pathway programme initiated by the Health Ministry.
The crux of the matter lies in MMC's reluctance to acknowledge postgraduate credentials from esteemed institutions such as the Fellowship of the Royal College of Surgeons of Edinburgh and the Master of Pathology (Medical Genetics) from USM.
Former deputy health minister Dr Lee Boon Chye said the Medical (Amendment) Act 2012 granted the MMC the responsibility of registering and managing the specialist registry, yet it lacked specifics on assessing specialists' qualifications.
"This highlights the need for new amendments to represent clear qualification criteria and provide multiple pathways for doctors to attain specialist status.
Lee said in the past, sub-specialist training predominantly relied on apprenticeship, where doctors accrued requisite years of experience at established institutions, documented through hands-on practice detailed in logbooks.
He said gradually, certain sub-specialties introduced structured training modules incorporating examinations and formal assessments leading to certification, indicating a foreseeable trend.
Lee who is also a former PKR MP further noted that the extent of these structured courses for sub or super specialists limited.
"For instance, while structured training is necessary to qualify as a cardiothoracic surgeon (CTS), a heart-lung transplant specialist (a CTS sub-specialist) can only gain qualification through apprenticeship and practical experience.
"Similarly, electrophysiologists, a subspecialty of cardiology, still obtain specialist qualifications through apprenticeship and hands-on training.
Consequently, he said some sub-specialties will continue to rely on apprenticeship rather than structured master training programmes.
Lee also highlighted that as the medical field underwent a transition from apprenticeship to structured training in select specialties, many sub-specialties lacked comprehensive structured pathways.
"Even within structured frameworks like cardiothoracic surgery, limitations exist.
"Recognising the importance of both structured pathways and apprenticeship systems, a rational approach is needed and it involves acknowledging their coexistence until structured pathways mature.
"Only when structured pathways are fully developed should local master programmes assume control, aligning with national interests and sovereignty.
"However, for local universities to assume control prematurely, without adequate capacity building, would be both premature and counterproductive," he said.
Meanwhile DAP veteran and medical practitioner Dr Tan Seng Giaw said that the Health Ministry (MOH) carried the responsibility of ensuring that competent specialists, including cardiothoracic surgeons, remained in Malaysia.
"Currently, there is a shortage of specialists in the country, estimated at approximately 25 per cent.
"If countries like the United Kingdom, Australia and New Zealand recognise the memberships of the Colleges of Physicians and Fellowships of the Colleges of Surgeons, there is no reason why Malaysia should not follow suit," he said.
Tan also said medical specialists must continuously demonstrate their commitment to patient care, prioritising their well-being above all other considerations.
"We should work towards creating conditions that discourage Malaysian specialists from emigrating, this issue is a brain drain.
"Those in positions of authority within the MOH must prioritise the nation's interests over personal agendas and it is imperative that doctors are not subjected to 'modern slavery.'
"Amendments to the Medical Act 1971 should guarantee the recognition of reputable specialist qualifications in the nation's best interest. Medicine should not be politicised," he added.
