KUALA LUMPUR, March 28 — Advocates of the Ministry of Health’s (MOH) parallel pathway programme for specialisation in medicine have gained a surprising ally in Higher Education Minister Zambry Abdul Kadir.
In the ongoing war between the MOH’s parallel pathway programme with overseas royal colleges and local universities’ Master programmes, Zambry even indicated that legislative amendments may be proposed to enable National Specialist Register (NSR) recognition of parallel pathway graduates as specialist doctors.
“The Cabinet has discussed this and we have agreed to form a task force to make a solid decision so that these two fields – the parallel pathway and programmes by public universities – can be resolved,” Zambry told Senator Dr RA Lingeshwaran in the Dewan Negara yesterday.
“We don’t want, for example, what’s happening today where there’s a problem in recognition. These protracted technical problems are preventing specialists who have completed their training from being absorbed.
“We hope for a resolution to the issue in the nearest time, including, if necessary, a few amendments to the current Act.
“Our country desperately needs these specialists, but because of such protracted technical problems, we are denying the rights of those who have completed their courses as specialist doctors. This actually is a loss to the country. Therefore, the government insists on a speedy solution.”
Zambry, who is a senator, did not indicate what legislative amendments might be proposed by the government, after the Malaysian Medical Council (MMC) recently rejected NSR registration applications from four pioneer graduates in the cardiothoracic surgery parallel pathway programme by the Royal College of Surgeons of Edinburgh (RCSEd).
Crucially, the higher education minister’s statement in the Senate yesterday omitted local universities’ concerns of quality, competence, and stringent standards with international specialisation training.
Zambry also told the Dewan Negara that the MOH projects 19,714 specialist doctors are needed in the country by 2030, with 11 public universities having medical schools, of which eight offer Master or Doctorate training in 24 specialist fields.
“Local public universities have produced 7,935 Master’s graduates in medicine as of 2023. In line with this, to deal with the shortage of specialist doctors, the MOH initiated the parallel pathway training in 14 fields to support the plan to increase the number of specialist doctors in the country.”
Dr Lingeshwaran, who is from the DAP, said earlier today that he held further discussions with Zambry on the parallel pathway issue after their interventions in the Dewan Negara.
“We discussed the Malaysian Qualifications Agency (MQA) requirement for medical specialist training. According to Section 3(2) of the Malaysian Qualifications Agency Act 2007, this Act is exempt from ‘professional programmes or professional qualifications’,” the senator wrote on Facebook.
“The higher education minister agreed with this view and feels regret with what happened with the recognition of the MOH’s parallel pathway programme because of technical issues.
“He expressed his and the government’s commitment to resolving this issue as quickly as possible because the fact is, the country needs many medical specialists and the Minister will help to ensure that the specialist training programmes under the Ministry of Higher Education and the MOH’s parallel pathway programme can be conducted concurrently for national interest.”
Health Minister Sees Solution Ahead
MMC – a statutory body which regulates the profession and practice of medicine in Malaysia – issued a statement last Monday to claim that it had never recognised the Fellow of Royal College of Surgeons of Edinburgh in Cardiothoracic Surgery, or FRCSEd in cardiothoracic surgery. This claim was rebutted by the Malaysian Medical Association Schomos.
When Dr Lingeshwaran highlighted contradictions between the statement by the MMC – which was issued by Dr Muhammad Radzi Abu Hassan, who is also the Health director-general overseeing the public service in the MOH – Health Minister Dzulkefly Ahmad was more circumspect in his answer.
“I don’t want to use the term ‘contradiction’, but I see a solution ahead. I’m drafting a memorandum to Cabinet on this,” Dzulkefly told the Dewan Negara yesterday.
He requested for more time before briefing the Senate on the proposed solution, citing the need for Cabinet approval of his memorandum.
“What is important is that our parallel pathway graduates will get all the facilities and the space needed to obtain recognition as specialists under the NSR.”
It is unclear how the Cabinet might be able to intervene in the parallel pathway issue without their intervention being perceived as inappropriate political interference in matters of the medical profession that are supposed to be regulated by the MMC as an independent statutory body.
UiTM Received MQA Provisional Registration for Cardiothoracic Surgery Programme
Dzulkefly previously told Dr Lingeshwaran in a written Dewan Negara reply last March 20 that specialist registration was placed under the jurisdiction of the MMC, subsequent to a 2017 amendment to the Medical Act 1971.
Section 14B of the Medical Act also lists a “recognised specialist qualification” as one of the criteria to be registered as a specialist doctor.
According to the health minister, four qualifications have been listed by the MMC for cardiothoracic surgery, all of which are international. Although MMC’s website does list “Fellow of Royal College of Surgeon (UK & Ireland) – Intercollegiate Specialty Board in Cardiothoracic Surgery”, the MMC’s statement last Monday clearly indicated that it did not recognise the Edinburgh qualification.
Dzulkefly added that 16 medical officers are currently undergoing training in the cardiothoracic surgery parallel pathway programmes, with the cost of six-year training amounting to RM250,000 per person.
Dr Lingeshwaran, who cited Dzulkefly’s reply, asked Zambry in the Senate yesterday how Universiti Teknologi Malaysia (UiTM) could then conduct cardiothoracic surgery training.
The higher education minister said UiTM has received provisional recognition from the MQA for its two-year Master in Surgical Science (Cardiothoracic) course. Doctors who complete this programme then need to join a four-year Doctorate of Cardiothoracic Surgery programme before they can register with the NSR.
“With this, UiTM is recognised as a training centre for cardiothoracic surgeons,” Zambry said.