Parallel Pathway Issue Turns Complex: Does MQA Act Need Amendments?

The parallel pathway issue has turned complex, after Cabinet was briefed about a conflict between MQA and MMC. Does MQA Act need amending, besides Medical Act? Zambry said a “kertas cadangan” will be tabled in Cabinet June 5; he didn’t use the term “memo”.

KUALA LUMPUR, May 30 — The parallel pathway issue has taken a complicated turn, with a question now arising on whether the Malaysian Qualifications Agency (MQA) Act 2007 needs to be amended alongside the Medical Act 1971.

Yesterday, Communications Minister Fahmi Fadzil, who is also the government spokesman, told a post-Cabinet press conference that the parallel pathway issue involved a conflict between the MQA and the Malaysian Medical Council (MMC).

Fahmi said Higher Education Minister Zambry Abdul Kadir and Attorney-General’s Chambers (AGC) representatives had briefed yesterday’s Cabinet meeting about the need to amend certain legislation, but Cabinet was not told specifically which law or whether one or multiple Acts would be involved.

Yesterday was the first time that a minister referenced MQA, a national body that accredits higher educational programmes and qualifications, in connection to the parallel pathway for medical specialty training, after months of the medical fraternity’s sole attention on the MMC and the Medical Act.

This indicates that the parallel pathway isn’t only about medicine, with MMC’s non-recognition of at least one parallel pathway programme – cardiothoracic surgery – possibly simply being the effect, rather than the cause, of problems in an issue of higher education.

So far, Health Minister Dzulkefly Ahmad has taken the lead on the parallel pathway issue, with the Ministry of Higher Education (MOHE) seemingly taking a back seat to the Ministry of Health (MOH). But if the Cabinet or the AGC decides that a package of legislative amendments to multiple laws is needed to achieve whatever objective (which have yet to be specified by either the health or higher education ministers) in the parallel pathway, this will likely delay the tabling of bills, especially if the bills involve the jurisdictions of both the MOHE and MOH.

The upcoming Dewan Rakyat meeting will be a short one scheduled for only four weeks from June 24 to July 18.

Zambry’s press statement yesterday, issued after the Cabinet meeting, omitted any mention of MQA or whether the MOHE was proposing amendments to the MQA Act.

“Like what was mentioned by the health minister in an April 2, 2024, press statement, the Medical Act 1971 (Act 50) will be amended to resolve a few arising issues, including registering medical officers who completed the parallel pathway medical specialty training,” Zambry said.

“In line with that, a comprehensive proposal paper (kertas cadangan) has been prepared and will be tabled by the health minister to Cabinet on June 5, 2024.”

Dzulkefly was absent from yesterday’s Cabinet meeting, as he is currently attending the 77th World Health Assembly in Geneva, Switzerland.

Zambry’s use of the term “kertas cadangan” is a striking difference from Dzulkefly’s previous use of the term “memo Jemaah Menteri” (Cabinet memorandum) to describe the document that the health minister plans to table to Cabinet on June 5. A Cabinet memorandum is a document usually intended for action.

Prof Dr Noor Hassim Ismail, head of the Group of Professors of Health and Medicine, urged the MOHE to enforce existing law, instead of amending the law to continue to allow irregularities in the MOH’s parallel pathway programmes with royal colleges in the UK.

“I think both ministers set a very bad precedent to the public without considering the effect of adopting non-recognised and proper quality assurance to produce specialists who will deal with people’s health,” he told CodeBlue briefly.

Section 14B of the Medical Act’s 2012 amendment, which came into effect in 2017, states specialised training in a “recognised training institution” as one of the criteria for a person to be entitled to specialist registration under the Act. Another criterion is holding a “recognised specialist qualification”.

Senior lawyer New Sin Yew previously told The Great Parallel Pathway Debate that a “recognised training institution” refers to a higher education provider, as defined under Section 2 of the MQA Act.

At the debate event, Galen Centre for Health and Social Policy chief executive Azrul Mohd Khalib asked who is legally accountable for parallel pathway training in Malaysia, pointing out that the MOH is not an institution of higher learning, whereas the Academy of Medicine of Malaysia is a society registered under the Registrar of Societies (RoS).

Azrul also pointed out that the MQA Act has been imposed on all new clinical programmes since 2007, with the national body tasked to conduct reviews, audits, and provide accreditation to educational institutions.

The MQA and MMC are under the jurisdictions of the MOHE and the MOH respectively.

Zambry said he told yesterday’s Cabinet meeting that there were two main issues with the MOH’s cardiothoracic surgery parallel pathway programme with the Royal College of Surgeons of Edinburgh: recognition of the parallel pathway and registration of parallel pathway graduates as specialists in the National Specialist Register (NSR) by the MMC.

He added that besides the cardiothoracic surgery postgraduate programme by a collaboration between Universiti Teknologi MARA (UiTM) and the National Heart Institute (IJN) – which is currently the country’s only such local programme – Universiti Malaya is also in the process of getting accreditation for a similar programme before it can be opened in the near future.

CodeBlue understands that a cardiothoracic surgery postgraduate programme should ideally have at least two full professors.

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