KUALA LUMPUR, April 2 – Senator Dr RA Lingeshwaran has called for reforms to increase transparency in the Malaysian Medical Council’s (MMC) decision-making process for postgraduate qualifications from both local universities and parallel pathway programmes.
The former Sungai Bakap hospital director in Penang said that recent issues with the parallel pathway programme serve as a “strong enough hint” that there are underlying problems within the MMC.
“First and foremost, we will need to reform the election process of the MMC. Can you believe that we are still using a postal vote system or the MMC election? Also, as far as I know, the results of the election as to how many total votes cast and total votes garnered by each candidate are not published widely.
“As for the recognising or derecognising a medical qualification, be it undergraduate or postgraduate qualifications, every decision and consideration by the Medical Education Committee (MEC) should be published in public domain with the accompanying reasons and relevant dates,” Dr Lingeshwaran told CodeBlue when contacted yesterday.
Dr Lingeshwaran said that postgraduate qualifications, decision, and consideration of the Specialty Subcommittees for Education (SSC-Edu) should also be made available in the public domain.
However, the DAP lawmaker noted that further amendments to the Medical Act should consider the interests of national health care and ensure substantial representation of the Ministry of Health (MOH) within the MMC.
Higher Education Minister Zambry Abdul Kadir told the Dewan Negara recently that the government was considering legal amendments to resolve the imbroglio between the MOH and MMC on the MOH’s parallel pathway programmes for specialist training in medicine with overseas royal colleges.
Under the Medical (Amendment) Act 2012, an update to the Medical Act 1971, which has been effective since July 1, 2017, the MMC is now legally authorised to recognise training institutions and qualifications for the registration of medical practitioners.
The MMC relies on recommendations from the Medical Education Committee (MEC), established by MMC, to confer such recognition to promote “high standards of medical education” and “coordinate all stages of medical training”.
The Specialty Subcommittees for Education (SSC-Edu), under the MEC, are tasked with evaluating training programmes for recognition.
Following amendments to the Medical Act, several medical programmes, both from local universities and royal colleges abroad, have since been excluded from the MMC’s list of recognised programmes in the National Specialist Register (NSR), forcing them to be re-accredited.
MMC’s council members consist of 33 representatives from recognised local universities, the private sector, public services, and elected medical practitioners. They are:
- the Health director-general (DG), who is president.
- nine fully registered medical practitioners from the representatives of recognised local universities and university colleges to be nominated from among the members of the faculty by the governing bodies of the respective recognised local universities and university colleges and appointed by the health minister.
- three fully registered medical practitioners from the private sector to be nominated by the council and appointed by the health minister.
- three fully registered medical practitioners from the public services to be nominated by the Health DG and appointed by the health minister.
- fifteen fully registered medical practitioners resident in Peninsular Malaysia to be elected by the fully registered medical practitioners resident in Peninsular Malaysia.
- one fully registered medical practitioner resident in Sabah to be elected by the fully registered medical practitioners resident in Sabah.
- one fully registered medical practitioner resident in Sarawak to be elected by the fully registered medical practitioners resident in Sarawak.
Out of the 33 MMC members, only 17 or just over half are elected, with the remaining 16 being appointed positions.
Council members are appointed for a term not exceeding three years.
Dr Lingeshwaran said more amendments to the Medical Act are needed to make the MMC presidency an elected post, instead of it going automatically to the Health DG.
“If you take cue from the General Medical Council of the United Kingdom, the chair of the Council is not one of the four Chief Medical Officers of the UK.
“Another thing to note [is] they also have lay members sitting on the council on top of registrant members. All the council meetings are [also] open to the public. This is the level of transparency that we need to strive for,” Dr Lingeshwaran said.
Dr Lingeshwaran also called for maintaining checks and balances instead of consolidating power within either the MMC or a minister, when asked if the Medical Act should be amended to grant the minister explicit powers to override the MMC in certain matters.
“I do not believe in absolute power as absolute power corrupts absolutely. Even more so, MMC is a body which regulates professional practice. If we have a minister who is not a medical professional, then we might have some issues there.
“Nonetheless, the minister should have the right to question the decision made by MMC and should have the power to appoint an independent committee made up of medical professionals to review any controversial decisions by MMC. That way, we can provide the necessary check and balance to MMC,” Dr Lingeshwaran said.
MMC has been the target of furore by some in the medical fraternity, particularly over its rejection last December of specialist registration applications with the National Specialist Register (NSR) by four pioneer graduates from the cardiothoracic surgery parallel pathway programme with the Royal College of Surgeons of Edinburgh (RCSEd).
The RCSEd, in an open letter to Health Minister Dzulkefly Ahmad, said the MMC’s rejection violated the principle of the partnership and work it undertook at the request of Malaysia’s Ministry of Health (MOH).
Yesterday, CodeBlue broke the story on a judicial review application by six pathology graduates in medical genetics from Universiti Sains Malaysia (USM) against the MMC’s refusal last August to register them on the NSR as specialist doctors.
The MMC, whose current president is Health DG Dr Muhammad Radzi Abu Hassan, did not recognise the Master of Pathology (Medical Genetics) qualification from the top local university, even though the postgraduate programme was recognised and accredited by the MOH, the Ministry of Higher Education (MOHE), and the Malaysian Qualifications Agency (MQA).
The six graduates aiming to be genetic pathologists had also received full scholarships from the MOH or the MOHE to pursue the four-year specialist programme.
Subsequent to completing their study, they also continued to receive specialist incentive payments from the government that are made only to medical practitioners recognised as specialists by the Health DG or an equivalent authority.
