KUALA LUMPUR, May 11 — In a Shakespearean twist, the Royal College of Surgeons of Edinburgh (RCSEd) now describes the cardiothoracic surgery parallel pathway as a “Malaysian qualification”.
RCSEd said the United Kingdom’s Medical Training (Prioritisation) Act 2026 did not affect the programme and that the royal college had no plans to halt its involvement, as it expressed its full commitment to the cardiothoracic surgery parallel pathway in Malaysia.
“The programme is a Malaysian qualification designed specifically to train surgeons for the Malaysian health care system,” an RCSEd spokesperson in Scotland told CodeBlue in a brief statement last Friday.
“Standard UK General Medical Council (GMC) registration requirements for international graduates remain unchanged.”
CodeBlue had asked RCSEd if the royal college was reviewing its cardiothoracic surgery parallel pathway in Malaysia and if the qualification was no longer fully recognised in the UK or if graduates have been deprioritised for jobs in the National Health Service (NHS), due to the UK’s new law.
Separately, the GMC told CodeBlue that the Medical Training (Prioritisation) Act “relates to the recruitment and allocation of training places and does not impact the GMC’s registration or fitness-to-practise processes”.
Schedule 4 on the List of Registrable Specialist Qualifications under Malaysia’s Medical (Amendment) Act 2024 lists the United Kingdom as the country “in which qualification is granted” for the Fellowship of the Royal College of Surgeons of Edinburgh in Cardiothoracic Surgery.
The UK’s Medical Training (Prioritisation) Act 2026 – which became law last March – prioritises UK medical graduates for foundation training places, while prioritising UK medical graduates and other doctors with “significant NHS experience” for specialty training positions.
The Medical Training (Prioritisation) Act is UK-wide and was drafted in close partnership with the Scottish government, the Welsh government, and the Northern Ireland executive, “creating a unified approach across the four nations”, according to NHS England.
Parallel pathway programmes by the Ministry of Health (MOH), such as cardiothoracic surgery, involve training in Malaysia, while exit examinations are provided by the royal college. This is different from a specialist who trained in the UK, although Malaysia-trained and UK-trained graduates received the same qualification—at least back then, now that RCSEd is making a distinction between both qualifications.
RCSEd’s current position that the cardiothoracic surgery parallel pathway is a “Malaysian” qualification marks a radical departure from its 2024 open letter to Health Minister Dzulkefly Ahmad, when the royal college said then that graduates were eligible to apply for specialist registration in the UK because the parallel pathway training and exam were of the same standards as in the home country.
It’s unclear if legal implications will arise from the RCSEd’s categorisation of the FRCS Edinburgh in Cardiothoracic Surgery as a “Malaysian” qualification, given that Malaysian law describes it as a UK qualification.
Established in 1505, the RCSEd is a fraternity of surgeons and the oldest surgical college in the world located in Edinburgh, Scotland.
The amendment to Malaysia’s Medical Act arose precisely because of the cardiothoracic surgery parallel pathway, after four graduates with FRCS Edinburgh in Cardiothoracic Surgery sued the Malaysian Medical Council (MMC) in 2024 for refusing to register them as specialists, due to MMC’s non-recognition of their qualification.
Malaysia subsequently listed FRCS Ed in Cardiothoracic Surgery under the 2024 amendment and radically revamped specialty training – to the extent of decoupling the Malaysian Qualifications Agency (MQA) from the Medical Act – only for the awarding institution to turn around and distance its home country from the parallel pathway.
In a double irony, Universiti Teknologi MARA’s (UiTM) postgraduate qualification in cardiothoracic surgery, the country’s first such home-grown programme unlike the apparently “Malaysian” FRCS Edinburgh, isn’t listed on Schedule 4 of the 2024 Medical Act amendment.
Parallel pathway proponents had repeatedly touted the “pedigree” of the RCSEd, based on a reasonable assumption that the FRCS Ed in Cardiothoracic Surgery was a UK qualification.
Prior to passage of the UK’s new medical training law, top RCSEd officials and former British High Commissioner to Malaysia Ailsa Terry reportedly insisted that Malaysian graduates from the cardiothoracic surgery parallel pathway could work in the UK because the GMC recognised their qualification.
Terry even posted on X in 2024 that the parallel pathway produced “qualifications from prestigious royal colleges”.
Nonetheless, RCSEd’s previous public statements about the cardiothoracic surgery parallel pathway didn’t explicitly use the term “UK qualification”.
The Malaysian Association for Thoracic and Cardiovascular Surgery (MATCVS) and Academy of Medicine of Malaysia (AMM) – which are co-organisers of the cardiothoracic surgery parallel pathway training, together with the MOH and RCSEd – had always suggested that the programme was a UK qualification recognised by the GMC.
Since RCSEd is now calling it a “Malaysian” qualification, the question is who is the local accredited body conferring the FRCS Ed in Cardiothoracic Surgery: MOH, MATCVS, AMM, or RCSEd’s international office in Putrajaya?
Despite RCSEd saying that the cardiothoracic surgery parallel pathway was intended to train doctors for Malaysia, some graduates took up jobs in the UK in 2025, according to a report by The Star last October.
Newcastle University, on the other hand, has maintained that the MBBS degree awarded by its Malaysian campus, Newcastle University Medicine Malaysia (NUMed), remains a “UK medical degree” accredited by the GMC.
All 103 NUMed medical graduates who applied for the 2026 UK Foundation Programme cycle were placed on a reserve list, following the Medical Training (Prioritisation) Act.
