No Cure for Medical Schools?

The response the expose made by the Director-General of Health Datuk Dr Ismail Merican, blogged here earlier, has been pretty extensive. In fact yesterday, the chief editor of the New Straits Times, Brendan Pereira gave our Deputy Minister of Higher Education Datuk Fu Ah Kiow some rarely witnessed public verbal slapping in his regular column Plain Talk.

Dr Ismail was doing Malaysians a great service by calling attention to this problem of theory-only doctors walking the corridors of hospitals here. He knew he was opening himself up for attack.

Just like clockwork, Deputy Higher Education Minister Datuk Fu Ah Kiow hit back with the language of a schoolyard bully. He said: "He should know better than to make sweeping statements."

Ouch. As Sdr Lim Kit Siang suggested, Datuk Fu might just be taking the knife for his boss (whose, if anyone has noticed, silence is just defeaning).

To add additional credibility to the case, Dr Ng Swee Choon, a cardiologist at the Sunway Medical Centre, who started blogging just this year at the Heart of the Matter, wrote a damning post with regards to the state of medical education in Malaysia. Dr Ng highlight three key issues leading to the falling standards of medical education in Malaysia - the politicisation of medical education, the removal of English as the medium of instruction at medical schools as well as the privatisation of medical education.

Just like the fact that the Kelantanese were promised a University in the event of the last by-elections victory, there appears to be a desire to have a medical college in every state hence the recently set up private colleges such as the Perak Medical School, Melaka-Manipal Medical College as well as the Penang Medical School.

More critically, Dr Ng alleged that there were medical colleges which were started with just one lecturer in each major field or department, with curriculum and facilities "planned [and built] as they go along".

One of the recent policy changes which I believe that the Government did right was to switch the medium of instruction for mathematics and science to the English language. However, as highlighted in an earlier post, the teaching of the science subjects at universities continues to be taught to a large extent in Bahasa Malaysia. To quote Dr Ng, once one is not fluent in the English language, one will "lose out in all the medical advances and progress".

And the first come, first served basis of setting up private medical schools have resulted in drastically lower standards in medical education.

Private medical schools are approved, without due study, but on "who is asking" to build basis. Everybody with a college wants a Medical school as it is prestigious. It's okay, even if we lower our standards, have part time lecturers, shared facilities, or scrape by with the barest minimum in facilities.

It is therefore not surprising to find that we have doctors who can't write medical reports, or make a clinical diagnosis. Some cannot conduct a proper medical examination, and some cannot treat. Have you seen doctors who perform surgery with a textbook openned next to him for step by step reference?

Ewww.... that's a really scary thought. But all these problems are not new, nor were they just highlighted recently. Trawling back the archives of statements made by Sdr Lim Kit Siang, you would find that he has called for a 10-year medical education masterplan almost 4 years ago when the then University Malaya Vice Chancellor Prof. Datuk Dr. Anuar Zaini Mohd Zain sounded the alarm over the decline in teaching standards in public and private medical schools, warning that a lack of qualified academic staff was affecting medical education and the quality of doctors produced.

Even then, Prof Datuk Dr Anuar have argued that the ratio of medical lectureres to students is too high at 1:16 when it is 1:5 in Singapore. If it is 1:16 at our top medical school, I can only expect much worse at our local private medical colleges. What is worse is that we are dealing with the shortage by importing foreign medical academic staff from Bangladesh, India and Myanmar - with apparently one college solely depending on these group of lecturers!

And not to mention the fact that we have a private medical college set up recently, Allianze College of Medical Sciences (ACMS) - whose website is inaccessible for weeks by the way - which is "twinning" with a less than assuring North Sumatra Medical University.

ACMS which is located at Menara Umno in Penang, was one of the institutions which "offered" places to 50 out of 99 students who scored 4As for the STPM who were denied places in the medical faculties in the local public universities. Unsurprisingly, only 4 accepted the places which meant the first 3 years of study in Medan, before returning for 3 years locally. Yes, that was how the Government "resolved" the top students denied entry controversy - by sending them to dodgy private colleges twinning with universities from a country with a poorer reputation in education than Malaysia.

While I may not agree with some of the recommendations made by Sdr Lim, his call for a concrete and specific policy to enhance and maintain the quality of medical education must be heeded. Unlike the other fields of the education, medicine is probably the most critical of courses to be dealt with, for it deals with human lives, and Malaysians' health should not be made to suffer for its bureaucratic incompetency.

We can only conclude that our medical education system is in need of surgery, and hopefully our policy makers can come up with the cure soon enough.