PUNCAK ALAM, May 2 — A senior consultant cardiothoracic surgeon has come to the defence of the Malaysian Medical Council (MMC), amid heavy criticism of the regulator for not recognising the parallel pathway.
Prof Dr Raja Amin Raja Mokhtar from the Department of Cardiovascular and Thoracic Surgery at the Faculty of Medicine at Universiti Teknologi MARA (UiTM) related an anecdote from more than a decade ago when he previously worked in a Malaysian hospital with a cardiothoracic surgeon certified by an American board.
That doctor was allegedly linked to several patient deaths before Dr Raja Amin joined the hospital. After he did an open-heart surgery on his own without Dr Raja Amin’s permission, in which the patient later died, the cardiothoracic surgeon resigned and returned to the United States.
“So those were the days before 2017 when we had no monitoring, no system. We just accepted anybody. ‘Oh American board, just take in’,” Dr Raja Amin told CodeBlue in an interview last April 22 at Hospital Al-Sultan Abdullah UiTM Puncak Alam.
“But now, we already have the system. We have the institution that can monitor and control and screen who should come in and who should not come in,” he added, referring to the MMC.
“And we’re telling them, ‘Oh no, you shouldn’t be doing it’. We’ve got our priorities wrong, I think. We need to remember that this institute, bodies like MMC, consist of many, many specialties, many, many people, very senior people.
“And it’s not one person’s decision. It’s everybody coming together. But we say ‘No, no, you can’t do this’. You have to believe them – just like GMC (UK General Medical Council) – you have to believe them”.
The 2012 amendment to the Medical Act 1971 and the Medical Regulations 2017 came into force on July 1, 2017, mandating that all doctors must be registered under this Act to practise as a specialist and ensure that they meet the necessary qualifications and standards set by the MMC.
Section 14B of the Medical Act was part of the 2012 amendment enforced in 2017 that mandates holding a “recognised specialist qualification” as among the criteria to be entitled to be registered as a specialist under the Act. MMC then became the legal guardian of the National Specialist Register (NSR).
Last December, the MMC rejected applications by four pioneer cardiothoracic surgery graduates of the Ministry of Health’s (MOH) parallel pathway training with a royal college from the UK to register as specialists on the NSR, as the MMC did not recognise the Fellowship of the Royal College of Surgeons of Edinburgh (FRCS Ed) in Cardiothoracic Surgery.
This triggered a lawsuit from the affected graduates and a very public and ugly war between advocates and opponents of the parallel pathway programme, with labels like “cartel” and “little Napoleons” thrown around, as local universities were accused of trying to be “gatekeepers” of medical specialty training in Malaysia.
Dr Raja Amin pointed out that under the cardiothoracic surgery postgraduate programme by a collaboration between UiTM and the National Heart Institute (IJN), trainees are supervised early, closely, and regularly in the country’s first such local programme.
“So when they come to our system, we subject them to this scanning. If we see they’re not ready, they’re not ready,” he said. “Our interest is to protect the public”.
Dr Raja Amin, who is also president of the Society of Thoracic Surgeons of Malaysia, stressed the importance of the Malaysian Qualifications Agency (MQA) and the MMC.
“They are there to make sure – okay, whatever you take in, you have to monitor properly whatever programmes from overseas,” he said.
“We look like the bad guys trying to stop; we’re not trying to stop anything. The basic point is that we are trying to protect the public.”
In a 2021 statement, then-MMC president Dr Noor Hisham Abdullah, who was also the Health director-general, said a meeting between the MMC, MQA, the MOH, and the Ministry of Higher Education (MOHE) had agreed that the parallel pathway for medical specialty training did not need MQA accreditation, since this programme is not offered by local higher education providers and the MOH merely provides facilities for candidates in sitting for examinations.
CodeBlue reported that contrary to claims that the FRCS Ed in Cardiothoracic Surgery is recognised by the UK’s GMC, the regulator’s website states that the Portfolio Pathway – which has been touted by the RCSEd for graduates to register as specialists in the UK – are for doctors who “haven’t completed a GMC approved programme of training”.
