KUALA LUMPUR, May 14 — The Ministry of Health (MOH) has dismissed a need to amend Schedule 4 of the Medical (Amendment) Act 2024, despite a royal college disassociating the United Kingdom from the parallel pathway.
The MOH perceived the UK’s new Medical Training (Prioritisation) Act 2026 as a “domestic” policy concerning the allocation and distribution of training positions within the country’s medical training system.
“Based on statements issued by the relevant parties in the UK, these changes do not affect professional registration processes or the regulation of medical practice under the General Medical Council (GMC),” the MOH told CodeBlue in a statement.
“Therefore, there is currently no need to amend Schedule 4 of the Medical Act in relation to the Fellowship of the Royal College of Surgeons of Edinburgh (FRCS Edinburgh) qualification in Cardiothoracic Surgery.”
It’s unclear why the statement was issued by the ministry in relation to CodeBlue’s questions about the Medical Act – instead of the Malaysian Medical Council (MMC) or Health Minister Dzulkefly Ahmad – given that specialist qualifications and the registration of specialist doctors are under MMC’s purview, not the ministry.
The Medical (Amendment) Act 2024 furnishes the health minister the power to amend Schedule 4 on the List of Registrable Specialist Qualifications, after consulting the Council.
Dr Mahathar Abd Wahab plays both roles as MMC president and Health director-general in the MOH.
The Royal College of Surgeons of Edinburgh (RCSEd) told CodeBlue recently that it considered the cardiothoracic surgery parallel pathway programme to be a “Malaysian qualification” designed specifically to train surgeons for the Malaysian health care system.
Its statement followed the UK’s Medical Training (Prioritisation) Act 2026 – which became law last March – that prioritises UK medical graduates for foundation training places, while prioritising UK medical graduates and other doctors with “significant NHS experience” for specialty training positions.
Schedule 4 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 MOH opined that RCSEd’s use of the term, “Malaysian qualification”, could relate to the implementation of the specialist training programme in Malaysia, rather than a change in the conferment of the professional qualification itself.
“The FRCS Edinburgh qualification in Cardiothoracic Surgery continues to be awarded by the Royal College of Surgeons of Edinburgh, and there has been no change to the status of the qualification to date,” said the MOH.
“A review of the GMC’s acceptable postgraduate qualification information also shows that the name and structure of the FRCS qualification remain unchanged.”
The GMC told CodeBlue in 2024 that it did not recognise the cardiothoracic surgery qualification from Malaysia’s parallel pathway programme with the RCSEd for specialist registration in the UK because the FRCS wasn’t a “primary medical qualification”.
The UK medical regulator said the qualification approved for the purpose of specialty training in the UK – which leads to the award of a certificate of completion of training (CCT) and subsequent recognition onto the specialist register – was the Intercollegiate Specialty Fellowship Examination (ISFE), not the FRCS.
It added that it had no legal powers to regulate the education of doctors “not in GMC-approved training” and that it was up to the royal college to award the FRCS Edinburgh qualification.
Last week, 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”.
The MOH believes there are no legal implications if Schedule 4 isn’t amended – in accordance with the RCSEd’s current position that the cardiothoracic surgery parallel pathway produces a “Malaysian” qualification – as long as specialist registration in Malaysia remains subject to the provisions under Section 14B of the Medical Act and assessment by the MMC.
“In Malaysia, the implementation of the Parallel Pathway Specialist Training Programme is managed by the MOH as the training provider, in accordance with Section 14B(3) of the Medical (Amendment) Act 2024,” said the ministry.
“The programme is also subject to the standards and training requirements set by the MMC, and is implemented based on the needs of the national health system and Malaysia’s regulatory framework.”
The MOH asserted that changes to the UK’s medical training policy did not affect the validity or implementation of the ministry’s parallel pathway programme, since the specialist training is conducted based on the needs of the national health care system and Malaysia’s regulatory framework.
“In certain circumstances, overseas training exposure may form part of the training component for some programmes, but this does not alter the fact that the entire training and assessment process is structured and regulated within a Malaysia-approved framework,” said the ministry.
“The MOH also continuously monitors developments in international specialist training policies and recognition, and remains in communication with relevant institutions and professional bodies from time to time to ensure that national specialist training standards continue to be safeguarded and aligned with the needs of Malaysia’s health care system.”
When asked if Universiti Teknologi MARA’s (UiTM) postgraduate cardiothoracic surgery qualification would be listed on Schedule 4, the MOH said any specialist training programme could be considered for recognition if it fulfilled requirements and standards set by the MMC and relevant regulatory bodies.
“Such consideration is subject to legal provisions, evaluation processes, and the applicable procedures currently in force.”
The MOH also dismissed a need to phase out its parallel pathways, stressing the “complementary roles” played by those programmes with foreign institutions and Master’s clinical programmes offered by local universities in developing Malaysia’s specialist workforce.
“Changes to medical training policy in the UK do not affect the validity or direction of locally implemented specialist training in Malaysia. Therefore, the MOH does not intend to discontinue the Parallel Pathway Specialist Training Programme.
“Instead, it will continue strengthening both national specialist training pathways to ensure that the country’s specialist workforce needs are met sustainably and with quality.
“At the same time, the MOH will continue exploring strategic collaborations with training institutions and related facilities to expand capacity and strengthen the ecosystem for specialist medical training in the country.”
