Friday, March 03, 2006

It's Raining Doctors

Well, according to an analysis by Malaysian Medical Association (MMA), we should be expecting a glut of doctors soon based on current trends. The MMA annual report for 2004 states taht at the current rate of growth, there will be a surplus of about 4,000 doctors by 2020. The New Straits Times reported that Datuk Dr N. Athimulam, the chairman of MMA's committee on medical education
observed that 1,200 new doctors graduated annually from local institutions, with seven more institutions of higher learning going to offer medical courses in the next few years.

Dr Athimulam said universities in Ukraine and Russia were producing about 15 to 20 Malaysian doctors now, but several hundred students were in their third, fourth and fifth years of study.
According to Dr Athimulam, the doctor-population ratio will rise from 1:1,361 to 1:400 by 2020. This, in theory is an extremely "commendable" ratio, comparable to the developed countries. However, while Dr Athimulam's concern is understandably the fact as "competition gets tougher... [n]ew doctors entering the market [will find] it hard to stay in the business", my personal concern is the quality of doctors and health service we will receive in the near future.

Dr Chris Anthony from Butterworth wrote in his letter to NST today, that the number of medical schools in Malaysia (17) "exceeds the number of medical schools in Singapore (one), Canada (16), Ireland (five) and Australia (11)."

He went on to criticise the local medical schools on two key points:
In the enthusiasm for increasing the number of doctors quickly, we have overlooked the two important prerequisites for the training of doctors. They are, first, adequate numbers of experienced qualified teachers who themselves are practising clinicians and a well- equipped teaching hospital.

If one were to scrutinise our medical schools, both public and private, hardly any of them fulfil these two criteria.
As it is, we have already heard comments on the quality of some of the output from the private medical schools leaves plenty to be desired. Director-general of Health Datuk Dr Ismail Merican said that there are many doctors in hospitals "who did not have clinical skills such as patient care, familiarity with the signs and symptoms of diseases, diagnosing illnesses, and doctor-patient communication" and focused his criticisms on the insufficiency of clinical training by many private colleges. See blog post here.

To compound my concerns on the quality, it was highlighted above that we are expecting a drastic increase in medical graduates from Ukraine and Russia in the coming years from the usual 15-20 graduates per annum currently. Once again, with all due respect to the universities in Ukraine and Russia, their education system in general do not inspire too much confidence. In addition, I understand that the universities which most Malaysians attend over there are often not the top universities of those countries. From what I dare speculate, these universities are merely taking the opportunity arising from excessive demand for medical education to gain valuable foreign exchange. It does appear that sometime down the road, it will become necessary for me to sight the qualifications of the doctor first before allowing myself to be examined by him or her.

As highlighted in the previous posts, MMA has as far back as 2002 called for major reforms and improvements to our local medical education system.

The Malaysian Medical Association (MMA) has raised, as far back as 2002, concerns with regards to the rapid increase in private medical colleges in Malaysia. They have raised their concern on the lack of trained and qualified lecturers, the worrying lecturer-student ratios in excess of 1:25 compared against 1:5 in the National University of Singapore as well as the non-standardisation of medical curriculum and examinations resulting in uneven standards, among other issues.

More critically, the Ministry of Higher Education should play a larger role in setting the necessary entry requirements and standards for the selection of students in all private medical colleges to prevent these colleges from placing their commercial interests above that of producing quality doctors.

In an issue which I'll blog about in another post, I'm extremely concerned that the Ministry of Higher Education has to date leaned heavily towards the commercialisation and privatisation of higher education in Malaysia, to the extent that the interest of the students, the public and the country in general has not been properly taken into the account.

Hence, it's unsurprising that Dr Athimulam urged the Government to "go slow" on permits for institutions of higher learning to conduct medical courses before it comes to a stage whereby we have "unemployable" doctors as well.

See also other related posts "Medicine: A Calling" and "No Cure for Medical Schools".


Anonymous said...

If u think the number of medical schools in malysia is growing at a shockingly fast pace...the try looking at the growth rate of pharmacy schools..will shock you even more
another point...a lot of the private medical schools are having 2 intakes per practically we have 'more than' 17 medical schools in Malaysia..
last point...a lot of very bright students..who should have gone into engineering, computer science, math or physics..are lured into med or pharm school because of the false illusions of 'shortage of doctors and pharmacists' painted by the recruitment officers of those 5 years time...we will definitely c a lot of unemployed doctors and pharmacists in Malaysia..mark my word..

Anonymous said...

Unemployed is one problem, "un"qualified is another.

Anonymous said...

IRO and CFA are co-organising a Malay Cultural Performance entitled "An Evening with Dato' Professor Dr Hashim Yaacob, Vice-Chancellor, University of Malaya [puisi - syair - silat - wayang kulit]" on 3 March 2006 at University Cultural Centre Courtyard, which is held in conjunction with the NUS Centennial Celebrations and NUS Arts Festival."

The response? No idea because i dont want to see him.

If the turnout was bad, Kapitan Hashim will just think that it was NUS's fault for not publicising about him enough.

But trust me, there's more than enough publicity in NUS. I just forgot to put it here since i was quite busy.

Anonymous said...

I always remember my relatives who keep saying without fail about choosing education course which finish fastest and it is 'buzzing' in the job market. Yes pharmacy is one of them.
MD however is something a bit more, it has status and promise wealth more than other careers.
The students however submit to this phenomena easilly and everybody rushed and jumped onto the band wagon. Yes actually Malaysia do have shortage of doctors, but that doesnt mean everybody is fit and has the discipline enough to be in that field to begin with. You would not want some half assed guy operating your brain or prescribing you something, would you? MD demands perfection because it is strictly dealing with human life.

My advise is, dont just go for something that you think will bring you more money instead find a career suitable for yourself, this is an illusion that many Malaysians are still dreaming about. They sell you an illusion of wealth but instead you found a lifetime of misery.


Anonymous said...

Medical courses are only for those who have the passion to heal the sick, those who think in terms of the $$$ will defintely be very disappointed and regret as the first few years ( the compulsory 1 year housemanship and the 3 years as a Medical Oficer in the public hospitals )is a killer.

In the pursuit for the degree they have to endure burning midnight candles practically every day as there are exams every other month.
A very sound advice from an under graduate who requested me to advise all my friends' and relatives' not to send their children to medical colleges unless they can endure the hours and hours of reading and to excel one must have some degree of photograhpic memory.

Anonymous said...

Definitely there will be surplus of doctors and pharmacists by 2020 from the speed the medical and pharmacy colleges are sprouting.
In addition, to enter to the private colleges Bs in either A- Levels or STPMS are sufficed.

Anonymous said...

Government should stop issuing licence to any new medical schools to be set up in this country. I would rather go to indonesian medical schools which have some 50+ years of teaching medicine then studying in this new "Un"experienced private medical schools which have no other reasons being set up besides making money from desperate "RICH" people who want to become doctors to be "MORE RICHER". Come on, one have to spend at least 300k to study medicine in our private medical school, those average wage earner surely wont be able to afford sending their children to do med in this private medical schools. More over i could list about 3-5 private medical school which dont even have MMC recognition. Why is the MMC being so concerned about the doctors who are going to graduate frm unrecognized universities in Russia and Ukraine when some private medical schools in our own backyard dont have MMC recognition?

Anonymous said...

Look.....dont be selfish! Its good to have many doctors as in CUBA. Everybody is assured of medical attention at lowest cost!
Dont discourage these doctors wanna bees!
Some more u can haggle the price with doctors and see who can give u the cheapest trearment!

Anonymous said...

Yes, money makes things possible. One of my students who is an SPM 3rd grader, cant complet college averagely either at pre-university level, playful, no sense of responsibility and care free... the last thing i heard, he was applying for medicine in Russia, dont know if he got it or not, coz if he did, well he would have graduated last year!!!!!!

Anonymous said...

Partly it's due to parents' obsession, that to be successful in life u must be doctors, lawyers and engineers.
I did a survey at a private college, and most students took up the courses that their parents want them to, not of their own interests. Then again, it's their parents' money, otherwise, they'd pull back the FAMA (father&mother la) scholarship.

Anonymous said...

It's people's attitute towards education, must get A, must be in A class, must get above 90 %, must this must that....

Parents should learn to relax, let our children take things easy, less mental problem in society, not pressure pressure pressures!!!

Like animals, children learn fastest when they play or rather when they are enjoying themselves.

I'm off topic? huh

Anonymous said...

U Talk About those not qualified to work on your health but u don't mind them building houses for u,growing rice for u,medicince is something which comes through practice,not just like some one has inborn knowledge of medice,of course everyone would like to be like akrit jaswal but practically think of the bigger picture here,give them some confidence and some assurance and i'm sure u will be in good hands.behind all those politics these all our children we are talking about...since now the exams have been implemented if u gave me a choice..u can forget the dr ratio to one patient coz i'd rather be trying for uk plab test or the USMLE than return and take the qualifying exam in malaysia and work my ass off and made fun off that i'm not from a recognized university.Lets see who gets the last laugh......

Anonymous said...

Quite interesting to note the Malysian government's attitude to private medical schools.
Since I've been based out of Malaysia for the past 2-3 decades, it is rather alarming to see the number of medical colleges. When I was commencing my undergraduate studies, there were only 3 universities providing a medical curriculum, out of which only UM had any degree of recognition outside of the country. Fast forward to today.
Where on earth can you find well qualified lecturers for so many schools? Especially since the government isn't even bankrolling them.
Remembered a conversation I had with a well known Prof of Medicine (who happens to be Malaysian)in Singapore a few years back. He was offered a position in one of the better known of these colleges, however the pay wasn't even what one of his junior MOs would earn. Needless to say, he is still working in Singapore.
Seems quantity is more important than quality. The converse seems to be true for Singapore, allowing a 2nd medical school only after much thought.

Anonymous said...

hello all. i'm a student from IMU

as a matter of fact, i would say that now our government is actually eating up their own words. just recently we have just recognised universities from poland to do medicine there and in fact government sponsored students have been sent there because the cost of education is much cheaper than the uk.

my point is that after the ukraine aftermath of derecognisation, why recognise another university which may cause another case of a high student enrollment there with very low A levels or STPM score?

isn't it going to be the same as before? derecognise CSMU and recognise some other polish university. what if the standards of education isn't much as different from russia? wouldn't it be back to square 1 where there's just quantity not quality?

medicine education should be monitored and best is if we take it up in a local university. we aim to come back here and serve, and very well should expose ourselves into our own local hospital setting and not going to somewhere CHEAP and try getting off with it when u're back here doing housemanship.

i've done attachments with russian and ukraine students during the holidays and i have to say their enthusiasm and knowledge is below par level. in fact those from yet to be accredited universities locally like ucsi and aimst are faring much better. lets not say those who are from PMC or perak medical college.

Anonymous said...

ogosh... you don't know the half of it... i used to attend a med-school in russia and to say the uni is lousy is an understatement... and yes, the school i went to happened to be one of the top 5 "recognised" by msia... i left after 2 years there, realising that staying would be very bad... i was fortunate to be able to start in another proper school... my uni is not an isolated case, i have a couple of friends from other "recognised" russian unis who also left... three of them got a place in local med school in msia two others went abroad... and we the students who left russia feel that we made the right choice of leaving... their medical education standards are very poor, their exam systems are very bad and prone for loopholes and manipulations... so many unimaginable problems but not many dare to speak up because scared of losing recognition so no job... the anonymous from imu was right when he described these students possess enthusiasm and knowledge that's below par... well, not all of them but certainly most of the students... the environment just doesn't promote seriousness of healthcare...

Anonymous said...

it is unhealthy and unfair to say and generalize all russian and ukranian medical universities as "lousy"...and to the one that had experiences being in attachments with students from ukraine and's the thing...comparatively students from local colleges and universities are equally the same when it comes to Q n A sessions during ward rounds....and this is from a personal experience of Questioning students during rounds...and to my suprise at times the student from Ukraine or Moscow or any other foreign university for that fact give better replies and responses to the questions tabled...and lets not compare them to IMU leavers ...coz they dont differ a single inch...Medicine is all about practice...and the interest and experience is the key to being a good doesnt matter where u graduate from is of what u become