KUALA LUMPUR, April 17 — The Malaysian Medical Council (MMC) has claimed ignorance of the National Specialist Register (NSR) website that it alleged had always been under the control of the Academy of Medicine of Malaysia (ASM).
MMC’s legal counsel from Kanesh Sundrum & Co – representing the statutory body that regulates the practice of medicine in Malaysia – also claimed that the Fellowship of the Royal College of Surgeons of Edinburgh in Cardiothoracic Surgery (FRCS Ed) was not included in the list of Recognised Specialty Qualifications handed over by AMM, a professional body, and approved by MMC and published on MMC’s website.
According to MMC’s lawyers, MMC approved the List of Specialties and Fields of Practice, as well as Recognised Specialty Qualifications, as handed over to the MMC by AMM in November 2017; this list was subsequently published on MMC’s website at www.mmc.gov.my.
“Our client had no knowledge of, and no control over, the contents of the NSR website, which at all times has been under the control of the AMM,” Jessica Ram Binwani from Kanesh Sundrum & Co. wrote in a letter dated last January 26, in response to a December 19, 2023 notice of demand issued by Steven Thiru & Sudhar Partnership.
Steven Thiru & Sudhar Partnership – representing Dr Syed Nasir Syed Hassan, Dr Nur Aziah Ismail, Dr Chong Kee Soon, and one more medical doctor – demanded that the MMC register its four clients with FRCS Ed qualification as cardiothoracic surgery specialists on the NSR, as they have successfully completed the parallel pathway programme after having passed the Joint Examination.
Dr Syed Nasir, Dr Nur Aziah, and Dr Chong, along with Dr Lok Yuh Ing (who’s not among the clients represented in the December 2023 notice of demand), subsequently filed a joint judicial review application in the High Court here last March 20 to contest MMC’s December 21 rejection of their NSR registration applications, as the MMC did not recognise their FRCS Ed postgraduate qualification.
In the notice of demand by Steven Thiru & Sudhar Partnership, the law firm claimed that MMC’s publication of a list of Recognised Postgraduate Qualifications on “its website” included FRCS Ed, and “therefore amounted to MMC’s public recognition” of the qualification from the parallel pathway training for purposes of registration on the NSR.
It added that this list including the FRCS Ed qualification was publicly available about as early as April 4, 2016 and was last seen on or about January 23, 2022.
“The FRCS Ed Qualification appears to have since been removed from the List of Recognised Qualifications without any notice to our clients and/ or to the other trainees on the Parallel Pathway programme,” said Steven Thiru, Jeremiah Rais, and Leah Samuel from Steven Thiru & Sudhar Partnership.
The law firm added that its clients had a “substantive legitimate expectation” that the MMC would register them as cardiothoracic surgery specialists on the NSR, as the statutory body’s recognition of the FRCS Ed qualification was “clear, unambiguous, and unequivocal as it was included in the List of Recognised Qualifications that was previously uploaded and made publicly available on MMC’s own website”.
Today, NSR’s website merely directs visitors to MMC’s website for specialist registration, besides a tool to search for specialists. MMC’s website lists Fellow of Royal College of Surgeon (UK & Ireland) – Intercollegiate Specialty Board in Cardiothoracic Surgery in a list of recognised postgraduate qualifications for cardiothoracic surgery.
Dr Noor Hisham Abdullah’s Involvement As Witness In Signing Of MOUs Was In Capacity As Health DG, Not MMC President
MMC’s lawyers from Kanesh Sundrum & Co. asserted that Dr Noor Hisham Abdullah’s involvement as a witness in the signing of various memorandums of understanding (MOUs) on the cardiothoracic surgery parallel pathway programme by the Royal College of Surgeons of Edinburgh (RCSEd) was done in his capacity as the Health director-general, not MMC president – to the best of MMC’s knowledge.
Under the Medical Act 1971, the Health DG is the MMC president. Dr Noor Hisham’s successor, Dr Muhammad Radzi Abu Hassan, is the current MMC president after he was appointed Health DG in April 2023.
“Our client has never made nor authorised any endorsements of the various MOUs executed by third parties,” said MMC’s legal counsel.
Steven Thiru & Sudhar Partnership cited three MOUs signed on August 28, 2014, February 28, 2018, and September 15, 2018 over the cardiothoracic surgery parallel pathway training by RCSEd and the extension of the Joint Examination to include Malaysia.
The legal counsel for four FRCS Ed graduates in cardiothoracic surgery also cited a November 26, 2019 email by Prof Dr Victor Lim Kok Eow, the then chairman of MMC’s Medical Education Committee (MEC), to the then honorary secretary of the Malaysian Association for Thoracic and Cardiovascular Surgeons (MATCVS), Prof Dr John Chan Kok Meng, that the FRCS Ed “is currently a recognised postgraduate qualification for registration with the NSR”.
However, MMC’s lawyers said in response that their client “does not accept that emails from any individual member of the Council, whether personal or otherwise, which are inconsistent with the decisions of the Council and the existing statutory framework, could possibly constitute representations which bind our client”.
Steven Thiru & Sudhar Partnership further highlighted a December 10, 2014 meeting by the Jawatankuasa Khas Perubatan (JKP) of the Ministry of Health (MOH) that agreed, inter alia, for the commencement of the parallel pathway programme in view of the need for cardiothoracic surgeons.
Subsequently, on March 13, 2015, the MOH issued a letter as a follow-up to the December 2014 meeting, informing MATCVS about JKP’s agreement to the parallel pathway training as the FRCS Ed qualification “has indeed been recognised as a specialist field by the government”.
MMC’s legal counsel, however, said in response that the MMC “does not consider itself bound by acts and/ or purported assurances by government officials, which are vague and/ or ambiguous, and in any event, are contrary to the existing statutory framework”.
From July 2017, Neither NCC, MOH, Or AMM Had ‘Any Further Role’ In Specialist Registration Or Recognition Of Postgraduate Qualifications
MMC’s lawyers explained that prior to July 1, 2017, the registration of specialists was carried out, “as a matter of policy”, by the National Credentialing Committee (NCC), comprising officials from the MOH and the AMM. The AMM functioned as the secretariat of the NCC before this date.
Then, the Medical (Amendment) Act 2012 – which came into force on that date – established a statutory framework for specialist registration, in which the Specialist Register was created as one of the divisions of the Medical Register. The MMC was empowered to carry out the registration of specialists in accordance with Sections 14A, 14B, and 14C of the Medical Act.
“The law also made it clear that applicants for specialist registration would have to comply with, among others, the requirements in Section 14B of the Act, one of which is to hold a recognised specialist qualification,” said Kanesh Sundrum & Co.
“Consequently, commencing 1.07.2017, neither the NCC, MOH or AMM had any further role to play with regard to the registration of specialists or the recognition of postgraduate qualifications. This task began to be carried out by our client within the new statutory framework as established by the amended Act.”
MMC also denied making any representations pertaining to recognition of the FRCS Ed in Cardiothoracic Surgery or acceptance of the qualification as fulfilment of the statutory requirements in Section 14B of the Medical Act.
