UiTM Hospital Plans Expansion Of Cardiothoracic Surgery Services

Hospital Al-Sultan Abdullah (HASA) UiTM in Puncak Alam plans to expand cardiothoracic surgery services to be fully operational by 2025. HASA director Prof Zamrin says the hospital targets 200 open heart surgery cases this year, after 120 performed in 2023.

PUNCAK ALAM, May 10 — Hospital Al-Sultan Abdullah (HASA), Universiti Teknologi MARA (UiTM), aims to expand cardiothoracic surgery services in its Puncak Alam facility for full operation by next year.

HASA director Prof Dr Mohd Zamrin Dimon – who is also a senior consultant cardiothoracic surgeon at the cardiovascular and thoracic surgery department at UiTM’s Faculty of Medicine – said the university hospital’s cardiothoracic services are primarily located in UiTM’s Sungai Buloh campus that hosts the Faculty of Medicine.

Most of HASA’s open heart surgeries are performed in Sungai Buloh, whereas thoracic services are provided in both Sungai Buloh and the Puncak Alam facility.

HASA, which is under a private finance initiative, is in the process of purchasing medical equipment to develop cardiothoracic services in Puncak Alam.

“By next year, hopefully, we can have full operation of HASA. We’ll still maintain Sungai Buloh, and then we will expand here in HASA,” Dr Zamrin told CodeBlue in an interview at HASA’s Puncak Alam facility last April 22.

He explained that HASA’s main hospital is in Puncak Alam, with additional facilities in UiTM’s Selayang campus besides the Sungai Buloh campus.

“In HASA, we have a lot of opportunities and room for expansion here because we still have a few OTs (operating theatres) which are not fully occupied. We are equipping that. Then the number of cases here – emergency – we have full coverage here,” Dr Zamrin said.

HASA’s Puncak Alam hospital serves a 700,000-strong population in the community, besides covering Kuala Selangor, Tanjong Karang, and Sabak Bernam in Selangor that do not have public hospitals providing cardiothoracic services. HASA in Puncak Alam even serves patients from Teluk Intan in the southern part of Perak.

HASA’s Sungai Buloh facility, Dr Zamrin said, has also received referrals from Sungai Buloh Hospital and Selayang Hospital under the Ministry of Health (MOH).

HASA, a tertiary hospital, has four cardiothoracic surgeons, plus another who is currently on secondment to the private sector who will return to the university hospital in two years’ time.

Currently, six trainees of the cardiothoracic surgery postgraduate programme by a collaboration between UiTM and the National Heart Institute (IJN) are undergoing training at HASA in various stages of study; the most senior ones are in their second year of doctorate, with another two years to go before graduation.

Dr Zamrin also mentioned a Pakistani doctor who graduated from Universiti Malaya’s Master’s of General Surgery who could potentially be recruited by HASA.

“In two years time, I think we will have more than enough cardiothoracic surgeons to serve HASA”.

Prof Dr Zainuddin Md Wazir, director of the UiTM-IJN cardiothoracic surgery postgraduate programme, previously told CodeBlue in an interview that there are currently 23 trainees overall with 22 supervisors.

Sufficient Open Heart Surgeries for Cardiothoracic Training

Hospital Al-Sultan Abdullah (HASA), Universiti Teknologi MARA (UiTM), in Puncak Alam, Selangor. Photo by HASA.

Dr Zamrin said there are sufficient cases at HASA for trainees of the UiTM-IJN cardiothoracic surgery postgraduate programme, with a ratio of 1 trainer to 2 trainees that is better than the recommended 1:4 ratio set by the Malaysian Medical Council (MMC).

Last year, due to structural issues from the renovation of HASA’s facility in Sungai Buloh, HASA performed 120 open heart surgeries in Puncak Alam, including coronary artery bypass surgery and heart block cases. This excludes thoracic cases.

“So the volume is enough for us,” said the HASA director.

He explained that UiTM-IJN cardiothoracic surgery trainees are required to acquire various skill-sets throughout their training in the six-year postgraduate programme (two years in Master’s and four years in Doctorate).

“How they conduct is very structured because for example, in every patient that we operate, we can accommodate at least three to four trainees at the same time. Different trainees will be located and trained in different areas – one trainee will open the chest; another trainee will open the veins, harvesting; another trainee will open up the radial artery,” Dr Zamrin said.

“So that’s how we organise in such a way. This is a very structured programme, very structured module, so we can modify or adjust according to the needs of the training.”

HASA targets performing 200 open heart surgery cases this year, increasing to 300 or more by 2025 in both the Sungai Buloh and Puncak Alam facilities.

“Our target is actually 500 cases by 2025 to 2026,” Dr Zamrin said. “The number of consultants that we have is enough and also the trainees.”

Only Three-Month Wait List For Heart Bypass Surgery At HASA

Dr Zamrin said the waiting list for a heart bypass at HASA is only about three months, even as the wait list in public hospitals for such coronary artery bypass graft (CABG) surgery can extend from six months to a year, according to the Malaysian Medical Association (MMA).

“Our capacity is much better. We have four consultants. You can name us which cardiac centre that has three professors and two associate professors – It’s only in UiTM.”

The HASA director added that the university hospital has offered to receive patients decanted from the MOH, citing the RM200 million allocation under Budget 2024 for the outsourcing of patients from the MOH to military, university, and private hospitals.

“Why do they want to keep patients on the waiting list for two years, whereas in university hospitals, we can do better, especially UiTM,” Dr Zamrin said. “So, we are ready to accept them.”

He said the MOH previously decanted 70 patients to HASA during the Covid pandemic. Post-Covid, the decanting exercise was supposed to have occurred by April this year, but the MOH has yet to send a single heart patient to the university hospital yet.

The average cost for a heart bypass surgery at HASA is around RM20,000 to RM25,000, or higher.

Dr Zamrin also does not believe that a fight for specialist manpower between the MOH and university hospitals is one of the factors driving the conflict over the MOH’s parallel pathway training with royal colleges in the United Kingdom, pointing out that most trainees in local Master’s programmes in medicine are from the MOH.

“We are not providing training only for our own consumption or usage. We are training for the whole nation. That is the mandate for the whole university,” he said.

“Our graduates will stay here because they are our employees. But at the same time, we are also taking in candidates from the Ministry of Health, and when they’ve completed, they will go back to MOH.”

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