KUALA LUMPUR, April 16 — The Malaysian Association for Thoracic and Cardiovascular Surgery (MATCVS) told parallel pathway opponents today that legislation like the Medical Act 1971 must follow policies of the government of the day, not the other way around.
In this case, the government policy under Prime Minister Anwar Ibrahim’s administration – in which Dzulkefly Ahmad is the current Health Minister – is to increase the number of specialist doctors in the country.
“Therefore, the noble Minister of Health as a government and rakyat representative must be supported in his crusade to propose amendments to the Medical Act in order to keep up with changing times and needs, plus ensuring smooth registration of specialists in Malaysia,” the MATCVS president Dr Basheer Ahamed Abdul Kareem and exco said in a lengthy 3,100-over word rebuttal of senior consultant paediatric surgeon Dr Dayang Anita Abdul Aziz’s criticism of the parallel pathway.
“We are perplexed with this obsession on following the law and the desire to become pseudo lawyers among senior doctors and even within the MMC (Malaysian Medical Council). The law is not gospel and certainly needs to be adapted to changing times. Chronicity doesn’t make flaws in the law right.”
MATCVS also told the MMC to publicly explain the “real reasons” for its rejection of the Fellowship of the Royal College of Surgeons of Edinburgh in Cardiothoracic Surgery (FRCS Ed) instead of merely citing legal clauses, after MMC rejected applications by at least four cardiothoracic surgery graduates with FRCS Ed to register as specialists on the National Specialist Register (NSR).
“Is it a simple issue of turf war or is there anything else? Furthermore, the MMC’s insistence on making major decisions with regards to Parallel Pathway Cardiothoracic Surgery without a single cardiothoracic surgeon being present during deliberations and within the appointed Task Force is mind-boggling. One wonders, who then is their subject matter expert?”
In a statement last March 25, MMC president Dr Muhammad Radzi Abu Hassan, who is also Health director-general in the Ministry of Health (MOH), claimed that the MMC had never, at any time, recognised the FRCS Ed in cardiothoracic surgery qualification from the parallel pathway programme. He added that the regulator has set up a task force to resolve this issue.
MATCVS’ statement today also refuted Dr Dayang Anita’s claim, in a recent interview with CodeBlue, that the government’s proposed amendments to the Medical Act to recognise parallel pathway training would allow the entry of allegedly “unsafe” specialist doctors.
“This statement is inappropriate unless she can furnish clear data and statistics on morbidity and mortality to support her claim that parallel specialists are unsafe, or else she is obviously ditching evidence-based medicine.”
MATCVS claimed that parallel pathway graduates are “easily employable” in the United Kingdom, Singapore, and Hong Kong, adding that pioneer specialists in Malaysia who were founding fathers of local Master’s programmes in the early 1980s and 1990s were themselves products of the parallel pathway.
“It will be insulting to say that they were unsafe specialists.”
Dr Dayang Anita had accused those who started the parallel pathway for medical specialty training of doing so “without due regard for laws”.
“Calling PP (parallel pathway) an illegal programme is certainly malicious in intent and we will categorise it as a personal opinion,” MATCVS said in response.
“We would like to remind Dr Dayang that even existing clauses in Medical Act – which are often quoted as reasons for rejection of PP – are just mere unilateral interpretation by MMC themselves after their corporatisation in 2017 and may not necessarily be shared by the rest of the legal fraternity, the Attorney-General’s Chambers, and judiciary”.
MATCVS further highlighted the irony in Dr Dayang’s qualifications being from the Royal College of Surgeons of Edinburgh (RCSEd), telling the paediatric surgeon to “promptly do the needful”, as the NSR website still lists her FRCS Ed even though she no longer pays annual fees to the overseas royal college to be able to use the qualification.
MATCVS explained that the cardiothoracic surgery (CTS) parallel pathway programme was started in 2014, “with full support of authorities” then, namely the MOH via the Jabatankuasa Khas Perubatan that was in charge of specialist recognition, “long before” MMC took over the job in 2017.
“Most efforts to start a local Master’s programme in CTS did not progress well at that time. PP in various specialties were mooted as a noble intention to provide many of our young doctors who were rejected from admission into Master’s programmes despite repeated applications with opportunity to further their training and concurrently address MOH increased specialist manpower needs with expansion of services nationwide”.
MATCVS said the Health director-general must remain as MMC president to safeguard the interests of the MOH, but called for fair representation of council members, especially MOH, and to avoid “skewed membership towards certain organisations”.
“Obligatory membership appointments for universities as per practice now must be avoided, although rightful fair number seats via voting can be allocated.
“MMC members must be voted in by a transparent digital system providing all 70,000 to 80,000 doctors in the country an opportunity to do so, unlike the current archaic postal ballot system which is open to rigging and manipulation. The number of winning votes has never been announced, but is believed to be in the range of about 2,000 votes only.”
MATCVS added that the tenure of MMC members must be limited to two terms, while the chief executive officer must similarly be appointed in “transparent” fashion and possess a second postgraduate degree, claiming that the regulator’s CEO now is merely a junior medical officer.
“At this juncture, the MATCVS would like to thank first and foremost the YB Minister of Health Datuk Seri Dr Dzulkefly Ahmad for his amazing commitment, wisdom, statesmanship, and brilliant efforts towards bringing this impasse to a closure with focus on rakyat health care,” said MATCVS.
“We would also like to thank YB Minister of Higher Education Datuk Seri Zambry Kadir for his fantastic understanding of the issue and clarifying the MOHE policy on this in parliament, although his own doctors in UKM seem to be in disagreement.
“The MATCVS would also like to express our sincere gratitude to other key stakeholders who supported the PP, namely the Malaysian Medical Association, the Academy of Medicine of Malaysia, Parliamentarians and Senators who have debated the issue in the august House, the Irish Embassy, the British High Commission, and many others who have backed the PP in social media”.
