KUALA LUMPUR, July 17 — The Dewan Rakyat today passed the Medical (Amendment) Bill 2024 that radically revamps medical specialty training, removing it from the exclusive purview of local universities.
The bill – which was passed in a voice vote after 19 MPs participated in a debate that began last night – decouples the Malaysian Qualifications Agency (MQA) from the Medical Act, concentrating sole power in the Malaysian Medical Council (MMC) to recognise specialist qualifications, training institutions, and training programmes.
This indicates that universities themselves no longer require MQA accreditation for their postgraduate medical programmes to be recognised by the MMC or for their graduates to be registered as specialists on the National Specialist Register (NSR), even as university programmes in other fields still require MQA accreditation.
The 2024 Medical amendment bill essentially legalised parallel pathway programmes – involving local medical specialist societies, the Ministry of Health (MOH), and foreign institutions – that began in 2014.
Alleged “irregularity” of local Master’s programmes in medicine that were started four decades ago – not just the parallel pathway – was only raised in recent days, with Health Minister Dzulkefly Ahmad attributing it to the Attorney-General’s Chambers (AGC) interpretation of “recognised training institutions” in the 2012 amendment of the Medical Act.
In other words, since MOH is not a “recognised training institution” as it isn’t a higher education provider, therefore local Master’s programmes that utilise MOH hospitals as specialty training centres are also “irregular”, just like the parallel pathway that uses the same training centres.
Among the 19 MPs who debated the bill, most were either from the DAP or PAS, with Pakatan Harapan (PH) lawmakers supporting it and Perikatan Nasional (PN) MPs opposing it or calling for referral of the bill to the Health parliament special select committee (PSSC).
On Opposition MPs’ concerns about the decoupling of MQA from the Medical Act and concentration of power in the MMC, Dzulkefly simply said in his winding-up of the debate that the panel of assessors for medical specialty training programmes would remain the same.
He also dismissed MPs’ questions about the quality of parallel pathway programmes as “irresponsible” statements, adding that MMC has standards for specialist training and specialty-specific requirements.
Other significant clauses in the Medical amendment bill are the “saving and transitional” clauses to register specialists and “specialised training” between July 1, 2017 (when the 2012 amendment came into force) and the date of coming into operation of the 2024 amendment.
A group of nine medical doctors has said that the inclusion of such doctors into the NSR, which would allow them to work as independent specialists without supervision, cannot be “automatic because the qualifications have not been evaluated according to the amendment.”
“I want to stress that we’re not opposing this bill because we want to stop MOH from producing more specialist doctors. But we don’t want to compromise on quality and competence that may risk patient safety, due to pressure to produce more specialists,” Kuala Nerus MP Dr Alias Razak from PAS told Parliament last night.
All the health minister said today was that he would not compromise on quality, without answering MPs’ specific questions during the debate.
“Don’t question the quality of our graduates who are now consultants or senior consultants.”
