Four Cardiothoracic Surgery Graduates With FRCS Edinburgh Qualification Sue MMC For NSR Registration

Four cardiothoracic surgery graduates with FRCS Edinburgh qualification have taken MMC to court for rejecting their NSR registration applications. They cite a 2021 statement by then-MMC president Dr Noor Hisham Abdullah that recognises parallel pathway.

KUALA LUMPUR, April 8 — Four graduates from the parallel pathway training with the Royal College of Surgeons of Edinburgh in cardiothoracic surgery have taken legal action against the Malaysian Medical Council (MMC) for refusing to register them on the National Specialist Register (NSR).

Dr Nur Aziah Ismail, Dr Syed Nasir Syed Hassan, Dr Chong Kee Soon, and Dr Lok Yuh Ing filed a joint judicial review application in the High Court here last March 20 to contest MMC’s rejection last December 21 of their NSR registration applications, based on non-recognition of their Fellowship of the Royal College of Surgeons of Edinburgh in Cardiothoracic Surgery (FRCS Ed) qualification.

According to court filings as sighted by CodeBlue, acting MMC chief executive officer Dr Mohamed Anas Mohamed Hussain’s letters to the four graduates, dated December 21, 2023, stated that MMC’s 435th meeting on October 17, 2023, had decided that the graduates were not entitled to be registered as specialists under the Medical Act 1971 because the MMC did not recognise their postgraduate qualification, citing Section 14B of the Medical Act.

“Section 14B is clear in that only practitioners with recognised specialist qualifications may be registered as specialists,” Dr Mohamed Anas said in his letters to the four.

“Please note that the list of recognised post-graduate qualifications is as endorsed by the Council in 2017 and published by the MMC on its website at

“Please be informed that the Council is in the process of facilitating the recognition of qualifications not included in the MMC list referred to above. The Council will be making an announcement regarding this process in due course.”

MMC then issued a press statement, under president and Health director-general Dr Muhammad Radzi Abu Hassan, last March 25 to deny having ever recognised, “at any time”, the FRCS Ed qualification, besides announcing that a task force has been set up to resolve the issue.

The first and third applicants in the judicial review application – Dr Nur Aziah and Dr Chong – are currently employed by the National Heart Institute (IJN), while the second and fourth applicants – Dr Syed Nasir and Dr Lok – are under the employment of the Ministry of Health (MOH). The four had passed the Joint Examination for their FRCS Ed in cardiothoracic surgery.

This is the third known lawsuit against the MMC’s rejection of NSR specialist registration applications, in which judicial review applications have been filed to legally challenge the independent regulatory body’s recent non-recognition of certain specialist training programmes.

The other two lawsuits were filed by a neurosurgeon with FRCS Ireland in neurosurgery and six pathology graduates in medical genetics from Universiti Sains Malaysia (USM), a local university. The High Court has granted leave for both judicial review applications.

Even before the four pioneer cardiothoracic surgery graduates from the Royal College of Surgeons of Edinburgh (RCSEd) commenced litigation last month, the MMC’s refusal to register them on the NSR was already widely discussed in the medical fraternity, triggering open calls from doctors’ groups for reform of the “opaque” statutory body that regulates the practice of medicine in Malaysia. 

Health Minister Dzulkefly Ahmad said in a statement last Tuesday that the MOH was proposing amendments to the Medical Act, pending Cabinet approval, for presentation to Parliament in June, even as he expressed support for parallel pathway trainees to be registered as specialists.

With at least three legal cases now involving the MMC, it is unknown how adversarial litigation will affect efforts to amend the Medical Act – and specifically the MMC’s decision-making process on specialist qualification recognition – that will likely require some consensus in stakeholder engagements. 

MMC’s 2021 Press Statement Recognised Parallel Pathway

In a statement filed at the High Court, the four applicants pointed out that then-Health director general and MMC president Dr Noor Hisham Abdullah had issued a press statement on August 27, 2014, saying that the parallel pathway programme would “become an alternative pathway to the current master of surgery programme in producing more cardiothoracic surgeons in the country.” 

The applicants also cited a November 26, 2019 email by an MMC member then and chairman of the MMC’s Medical Education Committee (MEC), Dr Victor Lim Kok Eow, to inform the Malaysian Association of Thoracic and Cardiovascular Surgery (MATCVS) that the FRCS Ed qualification “is currently a recognised postgraduate qualification for registration with the NSR”.

The applicants further cited a press statement on June 24, 2021, by Dr Noor Hisham, issued in his capacity as MMC president, that there are foreign qualifications known as the parallel pathway programme that are under the supervision of the MOH and do not need accreditation by the MQA, but are nonetheless recognised by the MMC.

“For the parallel pathways qualifications, the meeting agreed that the MQA accreditation process is not necessary, seeing that it’s not a training programme offered by local PPT (higher education provider) and the MOH merely provides facilities for the candidates in preparation for sitting for examinations,” Dr Noor Hisham said in his statement, referring to the MMC’s meeting on June 15, 2021.

He added that the MMC has recognised qualifications from both the local specialist training and parallel pathway programmes for the registration of specialist doctors on the NSR.

The applicants’ statement to the court also claimed that the MMC has published a list of recognised postgraduate qualifications that “listed the FRCS Ed Qualification without any reservation or qualification” on the NSR website.

“The Respondent also circulated an email dated 9.5.2023 which attached two separate versions of the List of Recognised Qualifications. Both versions listed and expressly recognised the FRCS Ed Qualification as a recognised qualification for the purposes of registering cardiothoracic surgery specialists on the NSR.”

In their judicial review application, the four applicants, represented by Steven Thiru & Sudhar Partnership, demanded for court orders to the MMC to recognise the FRCS Ed qualification as a “recognised specialist qualification” under Section 14B of the Medical Act and for the MMC to register them as specialists in cardiothoracic surgery on the NSR.

Hearing for leave for the judicial review application has been set in the High Court here on April 17. 

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