KUALA LUMPUR, April 22 — The Malaysian Association for Thoracic and Cardiovascular Surgery (MATCVS) has told opponents of the parallel pathway to quit public criticisms, after two ministers announced plans to move forward with amendments to the Medical Act 1971.
MATCVS – which has been at the forefront of pushing for recognition of the cardiothoracic surgery parallel pathway programme – said it would abide by Higher Education Minister Zambry Abdul Kadir’s call for a “ceasefire” in the parallel pathway conflict.
“We fully agree with this and humbly request all parties with constructive criticisms of the Cardiothoracic Parallel Pathway training to engage with us directly for further information, clarifications, and discussions, and avoid further unnecessary and often inaccurate and wrong negative public statements which are causing confusion to both the medical profession and the public,” the MATCVS executive council said in a statement yesterday.
Several academics – including the Group of Professors of Health and Medicine; retired professor of paediatric surgery Dr Dayang Anita Abdul Aziz from Universiti Kebangsaan Malaysia (UKM); former Universiti Teknologi MARA (UiTM) vice chancellor Prof Emeritus Ibrahim Shah Abu Shah; and Prof Hasan Mad from Universiti Putra Malaysia’s (UPM) board of directors – have publicly opposed attempts to recognise the parallel pathway for medical specialty training via amendments to the Medical Act, maintaining that local Master programmes should be prioritised instead.
Both advocates and opponents of the Ministry of Health’s (MOH) parallel pathway programme with overseas royal colleges have repeatedly accused each other of making inaccurate statements.
After a meeting last Thursday at the Ministry of Higher Education’s (MOHE) headquarters in Putrajaya, Zambry and Health Minister Dzulkefly Ahmad agreed to submit a joint memorandum to Cabinet for a Medical Act amendment bill to resolve the Malaysian Medical Council’s (MMC) non-recognition of graduates from the parallel pathway training, including cardiothoracic surgery.
Zambry said in a statement that the MOHE believes trainees and graduates should not be made “victims of circumstance”, due to “technical” problems that could be resolved.
“Based on that, MOHE and agencies below it, including the MQA (Malaysian Qualifications Agency), are open to discussions and a decision on efforts to achieve the national agenda to increase the number of medical specialists in the country, therefore ensuring that health service delivery under the MOH will be at an optimum level”.
Although MOH is the largest health care provider in Malaysia, multiple universities under the MOHE have been increasingly taking up the role of health care provision in the public sector by opening up their own teaching hospitals, despite a shortage of specialist doctors in the country.
Budget 2024 allocated RM1.7 billion for nine university hospitals, comprising about 14 per cent of MOHE’s RM12.2 billion budget.
Even the MOH has acknowledged the function of university hospitals as service hospitals – instead of operating purely as a teaching hospital and research centre – with Deputy Health Minister Lukanisman Awang Sauni telling Parliament in his winding-up speech last March 14 that the MOH did not see a need to construct a hospital in Petaling Jaya, Selangor, due to the existence of Universiti Malaya Medical Centre (UMMC), among other hospitals.
“We fully agree with both ministers, and others, that both the Parallel Pathway training and University Masters programmes must coexist unimpeded in the training landscape of this country to ensure that we produce the maximum number of specialists of the highest quality and standards utilising all our training capabilities and resources,” MATCVS said in its statement yesterday.
“The Cardiothoracic Parallel Pathway training and curriculum is quality assured by the Royal College of Surgeons of Edinburgh (RCSEd) and follows the same standards and requirements of the Malaysian National Postgraduate Medical Curriculum (NPMC) for Cardiothoracic Surgery, and the UK Intercollegiate Surgical Curriculum for Cardiothoracic Surgery regulated by the UK General Medical Council (GMC).
“The exit examination is the RCSEd Joint Specialty Fellowship (JSF) examination in Cardiothoracic Surgery. This examination follows the same standards and format as the Intercollegiate Specialty Board examination conducted in the UK and regulated by the GMC.
“This is the same and the only Cardiothoracic exit examination and qualification used in Hong Kong and Singapore, and fully recognised by both countries, and also in Brunei”.
MATCVS insisted that the Fellowship of the Royal College of Surgeons of Edinburgh (FRCS Ed) in Cardiothoracic Surgery is recognised by the UK GMC, as well as in Singapore, Hong Kong, and Brunei, claiming that the UK GMC has confirmed that graduates with that qualification are eligible for specialist registration in the United Kingdom.
MATCVS reiterated that the cardiothoracic parallel pathway does not use the JSCFE Cardiothoracic examination or the FRCS International qualification, “a totally unrelated and different examination and qualification, which is persistently quoted by some opponents of the Cardiothoracic Parallel Pathway training despite numerous clarifications by the MATCVS”.
CodeBlue reported last Friday that – similar to the MMC’s refusal to recognise the FRCS Ed in Cardiothoracic Surgery – the Membership of the Irish College of General Practitioners (MICGP) by the Malaysia-Ireland Training Programme for Family Medicine (MinTFM) isn’t included on MMC’s list of recognised postgraduate qualifications either, even though the family medicine parallel pathway programme is recognised by the Irish Medical Council.
The first batch of MinTFM graduates in Malaysia are expected to complete gazettement in the MOH by July, after which they need to apply to be registered as specialists on the National Specialist Register (NSR).
The Malaysian Family Medicine Specialists’ Association (FMSA) expressed appreciation to Dzulkefly and Zambry for attempting to resolve the parallel pathway issue that needs to be “scrutinised with great care, akin to finding a needle in a haystack”.
“In Malaysia, Family Medicine Specialists from different training backgrounds have been working together in training, clinical practice and research etc all these while. Our common aim is to elevate the quality of service in primary care delivery in the country,” FMSA said in a brief statement yesterday.
Malaysian Medical Association (MMA) president Dr Azizan Abdul Aziz similarly commended the joint efforts between the MOH and MOHE to resolve the parallel pathway imbroglio.
“Indeed, constructive dialogue and a spirit of collaboration among all parties concerned with regards to the issue is the way forward,” Dr Azizan said in a statement last Saturday.
“It is time all parties unite and work together towards the shared goal of addressing the acute shortages of medical specialists in the country and achieving the national target of 28,000 specialists by 2030”.
