KUALA LUMPUR, April 8 — A Malaysian neurosurgeon, who is currently based in Hong Kong, has taken the Malaysian Medical Council (MMC) to court for rejecting his application to be registered as a specialist on the National Specialist Register (NSR).
Dr Gabriel Lu Yeow Yuen – who is a Fellow of the Royal College of Surgeons in Ireland (FRCS Ire) in the specialty of neurosurgery after having completed the Joint Surgical Colleges Fellowship Examination held in Sri Lanka – filed a judicial review application last January 16, naming MMC and the Registrar of Medical Practitioners.
The High Court here granted him leave last March 26 to pursue his judicial review.
The MMC – which regulates the practice of medicine in Malaysia – informed Dr Lu on October 17 last year that it would not be able to register him on the NSR because his qualification was not in the list of recognised postgraduate qualifications.
MMC’s letter cited Section 14B(c) of the Medical Act (MA) 1971 that mandates holding a “recognised specialist qualification” as one of the requirements to be registered as a specialist.
Dr Lu, however, pointed out that MMC’s website lists Fellow of the Royal College of Surgeons (Edin, Eng, Glas, Ire), Intercollegiate Specialty Board of Neurosurgery as one of the recognised postgraduate qualifications for the specialisation of neurosurgery.
These qualifications refer to Edinburgh, England, Glasgow, and Ireland respectively.
“R1 (MMC) failed to explain how FRCS(Ire), which is listed as a recognised postgraduate qualification, is not a recognised postgraduate qualification under S.14B MA 1971,” Dr Lu said in an affidavit filed in the High Court here last January 16, as sighted by CodeBlue.
Dr Lu’s affidavit stated that due to MMC’s rejection of his application to be registered as a specialist on the NSR, he was “prevented from and deprived from exercising his right to returning to his home country, Malaysia, to serve as a registered neurosurgeon”.
Besides his FRCS Ireland qualification in neurosurgery that he obtained from the Royal College of Surgeons in Ireland (RCSI) in Dublin in 2018, Dr Lu is also a Fellow of the European Board of Neurological Surgery (FEBNS).
“I want to come back because I am literally anak Malaysia and I love my country. I was trained by Malaysians; I would love to give back to my Malaysian society,” Dr Lu told CodeBlue when contacted.
His wife, an aboriginal Sarawakian Kenyah, and three sons aged between four and 13 years old, currently live in Kuala Lumpur. Dr Lu, who is Pahang-born, has been apart from his family for five years since 2019 when he moved to Hong Kong, flying back to see them every one to two months.
Skull Base Team Coordinator for Neurosurgery, Neurosurgery Pain Service Coordinator
Dr Lu has been practising as a service resident in the Division of Neurosurgery, Department of Surgery, at Prince of Wales Hospital (PWH) in Hong Kong since October 2019. He is also currently an associate consultant in the Faculty of Medicine at the Chinese University of Hong Kong (CUHK).
According to his CV filed in court, Dr Lu is a skull base team coordinator for neurosurgery in PWH, as well as a neurosurgery pain service coordinator in the hospital. His neurosurgery subspecialty interests are in skull base surgery, neurovascular surgery, spinal surgery, and pain intervention.
As of June 30 last year, the 42-year-old said he has conducted 697 surgeries (689 of which, as a surgeon) during his tenure at PWH Hong Kong.
Prior to his work in Hong Kong, Dr Lu conducted 384 operations as the surgeon throughout his tenure as a neurosurgery senior staff physician at Khoo Teck Puat Hospital (KTPH) in Singapore from November 2016 to September 2019.
Before KTPH, Dr Lu conducted 915 operations (858 of which, as a surgeon) when he was the chief neurosurgery registrar in the National University Hospital (NUH) in Singapore from April 2013 to October 2016.
Between August 2011 and March 2013, Dr Lu practised as a service resident or junior neurosurgical trainee in the Division of Neurosurgery at the Department of Surgery at PWH in Hong Kong, where he maintained a surgical logbook that recorded at least 120 surgeries being performed per year.
Prior to that, between August 2008 and July 2011, Dr Lu served Sarawak General Hospital (SGH) as a medical officer in the neurosurgery department.
NSR Registration Application Deferred in December 2022, ‘Equivalency Study’ Required, Application Then Rejected in October 2023
MMC wrote a letter to Dr Lu on December 29, 2021, to inform him that MMC’s 413th meeting on December 21, 2021, had debated his registration application to be registered under the Medical Act as a specialist in neurosurgery.
MMC’s letter, which was among the court filings sighted by CodeBlue, stated that MMC had agreed with a recommendation by the Jawatankuasa Penilaian Kelayakan Pakar Perubatan (JKP 2) to defer his application pending the Medical Education Committee’s (MEC) evaluation of both of Dr Lu’s postgraduate qualifications: Fellow of Royal College of Surgeons in Ireland (Neurosurgery), Joint Surgical Colleges Fellowship Examination, Colombo, Sri Lanka, as well as Fellow of the European Board of Neurological Surgery.
Then, on December 22, 2022, then-MMC chief executive officer Dr Mohd Khairi Yakub wrote to Dr Lu, informing him that his application to be registered as a specialist in neurosurgery has been deferred, given that his postgraduate qualification was not a recognised qualification by the MMC and required an “Equivalency Study”.
“Please be informed that the MMC in its 424th meeting dated 22nd November 2022 has decided that your application to be registered as a Specialist cannot be processed at this time due to legal constraints,” said Dr Mohd Khairi.
In a letter to MMC on January 3, 2023 – after the 15th general election that saw the formation of the Pakatan Harapan-Barisan Nasional coalition government under Prime Minister Anwar Ibrahim – Dr Lu expressed “great hope of new Malaysia” and his readiness to return to serve his home country.
“In view of the need for Equivalency Study, is the due process started as I am certain Malaysian Medical Council has precedencies [sic] in dealing with such scenarios,” Dr Lu wrote.
Finally, on October 17, 2023, MMC wrote a letter to Dr Lu – this time under MMC CEO Dr Mohd Khairi’s successor, acting CEO Dr Mohamed Anas Mohamed Hussain – to formally reject Dr Lu’s application to be registered on the NSR, saying that his qualification was “not in the recognised list of postgraduate qualification”. This letter triggered Dr Lu’s legal action.
Dr Lu’s case before the MMC spanned two different Council presidents: Dr Noor Hisham Abdullah and now, Dr Muhammad Radzi Abu Hassan who succeeded Dr Noor Hisham as Health director-general in April 2023. Under the Medical Act, the Health DG is the MMC president.
This is the second recent lawsuit against the MMC over its rejection of NSR registration applications due to non-recognition of postgraduate qualifications, as well as a second known case involving MMC rejecting specialist qualifications from the Ministry of Health’s (MOH) parallel pathway training with overseas royal colleges in the United Kingdom.
Last November, six pathology graduates in medical genetics from Universiti Sains Malaysia (USM) filed a judicial review application to contest MMC’s rejection of their applications to be registered as specialists under the NSR. Their application was granted leave by the High Court in January this year.
MMC had demanded reaccreditation of USM’s Master of Pathology (Medical Genetics) programme offered by the top local university’s School of Medical Sciences.
Like the USM case, the Attorney-General’s Chambers (AGC) also declined to participate in Dr Lu’s case, writing to the High Court last March 22 that it had no objections to the judicial review application and that the AGC was not representing the respondents at the substantive stage.
Under the Medical Act, MMC members are considered public servants while discharging their duties in the council.
Meanwhile, MMC’s rejection last December of NSR registration applications by four pioneer graduates from the Royal College of Surgeons of Edinburgh in cardiothoracic surgery (FRCS Ed) triggered massive outcry in the medical fraternity, and even forced Health Minister Dzulkefly Ahmad to meet with the UK deputy high commissioner and the Ireland ambassador.
It is unknown if the cardiothoracic surgery graduates had filed suit.
