A Rebuttal To Parallel Pathway Opponents — Dr Rajeentheran Suntheralingam

In a rebuttal to paediatric surgeon Dr Dayang Anita’s criticism of the parallel pathway for specialisation, urologist Dr Rajeentheran clarifies several misconceptions, including non-equivalency between the parallel pathway and local Master’s programmes.

I refer to senior consultant paediatric surgeon Dr Dayang Anita Abdul Aziz’s interview with CodeBlue, as published on April 12 in the article titled: “Proposed Medical Act Amendment ‘Huge Mistake’ With Non-Accredited Parallel Pathway: Paediatric Surgeon”.

This matter has already been sorted out at the highest level; the Health Minister is bringing proposed Medical Act amendments to the Cabinet and Parliament.

If one is willing to publish such statements publicly, they must then be ready to be heavily criticised for them as well.

Firstly, Dr Dayang is criticising and questioning her own qualification, namely the postgraduate qualification from the Royal College of Surgeons of Edinburgh, conferred as a Fellow in 2000 (FRCS Edinburgh UK) – the parallel pathway programme that she actually went through in the first place.

She went through a certain pathway in becoming a surgeon, but now feels that others cannot do the same. Looks like what is good for the goose does not seem to be good for the gander.

I will rebut each of her points, as below:

“In the end, are we really producing safe specialists? We amend the law to let them in”.

Do opponents even know what the parallel programme is all about? Is it just about passing the FRCS exams only?

“Local postgraduate programmes are run by trained lecturers, accredited universities, supervised by Conjoined Specialty Committees, and monitored by rules and regulations”.

Are opponents aware that there is an appointed training Board, represented by hundreds of specialists in that specialty, that runs a supervised training programme with log books, referee assessment, annual monitoring of competency and exams annually or bianually?

Do they know the difference between FRCS with the Certificate of Completion of Specialist Training (CCST), FRCS conjoined with Board of Specialists managed by the professional body (under the auspices of the Ministry of Health and a memorandum of understanding with the Royal Colleges) represented by hundreds of specialists, and that of the FRCS International?

“The parallel pathway is not equivalent to local Master’s programmes”.

This is correct, though not in the implied manner. The FRCS is overseen by a third party internationally acknowledged group of clinicians and run by a Specialist Board represented by all the hundreds of specialists concerned (public, private and universities).

However, the local University programme is run by just a handful of specialists in the University, with the help of a few appointed local third party specialists.

“The training of undergraduates and postgraduates for medical specialties falls under the statute of the Ministry of Higher Education (MOHE)”.

This is completely wrong. This may apply to undergraduate training, but post-graduate training should be managed by professional bodies that represent all the specific specialists in the country, and not by University lecturers. It is time that the law is amended to provide for this.

“The training of specialists starts from looking at their qualifications to enter the programme, going through proper curriculum and modules, and standards assessments. If they don’t perform, we can terminate them”.

The parallel programme that we are talking about is NOT the FRCS International.

“With the current law, they cannot enter the National Specialist Register (NSR)”.

Of course, but opponents should be reminded that these are man-made laws, not God-written scriptures. It is not part of the Ten Commandments.

Whatever laws made by man can be amended by man as well. When a law is unreasonable, it should be promptly amended.

As a conclusion, this is exactly what all doctors were generally concerned about when the Medical Act 1971 (Amendment 2012), Medical Regulations 2017, and the NSR were enforced in 2017 – that there would be little Napoleons micromanaging this and giving their own criteria of whom should or should not be a specialist and attain the NSR.

Dr Rajeentheran Suntheralingam is a senior consultant urologist and urological surgeon. MBBS, FRCS (Edin), FRCS (Glasgow), FRCS Urology (Glasgow), Urology Board Certificate (Mal), AM (Mal)

Dr Rajeentheran was trained under the Board of Urology Malaysia after initially attaining his Fellowship from the Royal Colleges of Surgeons of Edinburgh and Glasgow, and subsequently underwent further training in the specialty of Urology at the Bristol Urological Institute, United Kingdom: training in the fields of Urodynamics, Incontinence Surgery and Female Urology, Andrology, Laparoscopic Urology and Uro-Oncology. His special interest lies in the field of Uro-Oncology and Female Urology, Neuro-urology and Urodynamics.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

You may also like