University Recognition Review
From The Star,
Perhaps this move has been long overdue. However, this process should remain unbiased despite inevitable pressures from certain quarters. All universities should be subjected to a similar evaluation process. Recommendations for improvements and a reasonable grace period should also be given if flaws are detected, unless there are gross violations of an accepted standard. I believe local public and private universities should not be exempted from this exercise. If the initial intention is to safeguard the interest of patients, then action should be taken without fear or favour, even if it means revoking recognition to local varsities.
Despite the probable wise move to derecognise Crimea State Medical University, the lack of transparency in the process has led many quarters to cry foul. Perhaps the MMC should reveal and explain the process of recognition and derecognition in greater detail. This is to avoid unnecessary harassment in the event another university is found unfit for recognition.
I believe we are heading in the right direction. However, how we get there is probably subject to debate.
Blog aggregator update
I have fixed the Aggregator feeds.
I took the opportunity to update and add more feeds (mostly students, no surprise here) to the aggregator.
If I have missed out anyone, please let me know.
Malaysian Medical Blog Aggregator v 1.1 (Doctors)Malaysian Medical Blog Aggregator v 1.1 (Students)Added two more student blogs to the blogroll (you know who you are!)
Asian patients
I had this encounter recently.
An elderly patient presents with very low blood counts (all three cell llines - red cells, platelets and white cells - were low)
Me (after taking a detailed history and performing a thorough physical examination): It is quite possible the low blood counts are due to a problem in the bone marrow and it may be several possiblities here (pernicious anaemia, myelodysplastic syndrome, aplastic anaemia). We need to determine the cause and a bone marrow examination is the next step.
Patient: Will it be painful?
Me: No, it will be only slightly painful as it will be done under local anaesthesia and you will be given sedation
Relatives: What supplements can you give her?
Me: We need to establish the correct diagnosis first
Relatives: Yes, but what medicines or supplements can you give to boost her blood counts?
Me : The correct treatment will follow the correct diagnosis
Relatives: But surely you can give something to boost her blood in the meantime?
Me : Not to worry once, a bone marrow is done we will be giving her LOTS of supplements to boost her counts.
As it turned out she had Megaloblastic changes in her marrow and the likely diagnosis is
Pernicious Anaemia which causes low blood counts due to the inability to absorb vitamin B12. So the treatment is to administer Injections of B12 (for life)!
The point I am trying to make here is we see so many of our patients and relatives who want instant cures and quick fixes for their problems/symptoms without any desire to try to understand the underlying disorder or to know the correct diagnosis.
I think alot of this stems from a poor understanding and knowledge of how our body works. This is also colored by alot of traditional and Asian beliefs.
Those of you who have worked in Western countries would realise a different way of thinking amongst Western patients.
Western patient: Why are you giving me those tablets?
Asian patient: Why aren't you giving me any tablets/injection?
Discuss in MMR Forums
Health Information Technology : The Way Forward
Undoubtedly, digital technology has revolutionised the way we communicate and live. It has spread its tentacles to influence every facet of everyday life from cell phones to computers. Life is quite unimaginable without these digital gadgetary. Utilising information technology in healthcare is nothing new. However, many doctors remain resistant to incorporating information technology as part of patient care.
Imagine assessing patient information or laboratory and investigative data with handheld devices via wireless connectivity to a central server. How about virtual consultations with colleagues in a distant center? Such ideas are probably nothing new. However, its utilisation should be more widespread. I support the incorporation of the subject of health information technology as a component of both undergraduate and postgraduate training programmes. We need a digital revolution among healthcare professionals and it should no longer be confined to a few gadgetary freaks!
Discuss in MMR Forums
Itching to blame NS training
From the NST,
NS girl suffers from psoriasis
ALOR STAR, KEDAH, Tues.
Home has been a prison for Nor Ermilia Abdullah since last May, when she broke out in red blotches during her National Service (NS) training in Merbok..... |
The publication of the above article has created a sense that the National Service programme has led these girls to suffer from skin diseases like psoriasis.
| "I am so sad that this has happened to me. I was healthy before National Service," she said at her Kampung Hilir home near Kepala Batas. |
It went on to say,
| Siti Salmiah said she decided to make her daughter’s condition public after reading about NS trainee Noraini Abu Bakar, who suffers from systemic lupus erythematosus. The disease flared up during her NS training in Cherating, Pahang. |
Perhaps the media has to be educated regarding diseases like SLE and psoriasis. I cannot help but get the impression that the public may be misled into thinking that these diseases are directly due to the National Service programmes.
Blogroll update
Added more medical student blogs
Australian-chronicles (a peek at a med students life down under)
Mixed-up Medical Muppet (life in Scotland)
My Little Moments (med student in Melbourne)
ihs4n: Journey to the past (med student in Ireland)
Welcome to the MMR Blogroll!
The Medical Blog Aggregator (students and doctors) is DOWN temporarily due to server problems (in case anyone actually noticed!)
Site update: MMC registration & Private page
I have updated the
Medical students and foreign doctors link on the right hand side of the MMR's front page with useful information from the MMA which details:
- Guidelines for Full Registration with the Malaysian Medical Council for Foreign Medical Officers
- Guidelines For Full Registration With The Malaysia Medical Council For Malaysia Citizens
and
-How to Apply for MMC Registration
I notice that people are still commenting to that post including a query from an Indian passport holder studying in Ukraine.
Please note that Foreign medical officers (M.O.) are only allowed to work in the public sector. This means that in the first place they need to apply for a job with the Ministry of Health or Education. Links to the MOH and the various Universities are availabe in the MMR.
I have also updated the
MMR Private hospital and clinic listing to reflect a change in Klinik Rohaya to Klinik Nur `Aina. Any other clinic websites out there?
Advertising
The medical profession has always been bound by ethics and strict guidelines when it comes to advertising.
In
Medical Practitioners Allowed To Provide Basic Information On Services, I think it is good that there is some loosening of what is perhaps overly strict and rigid rules.
Health Minister Datuk Dr Chua Soi Lek announced Tuesday that they could now provide basic information according to disciplines, names, places of practice and credentials but without mentioning experiences or using superlatives.
The information, together with photographs of the practitioners or institutions, could be conveyed through websites, yellow pages and the newspapers, he told reporters after opening the Association of Private Hospitals Malaysia (APHM) Healthcare Conference at Seri Kembangan, near here.
"However, we still require such information to be submitted for vetting and approval by the Malaysian Medical Advertisement Board," he said. |
All well and good. However there should be a better system at hand for verifying who is a bonafide doctor or specialist. Anyone can claim in a website he or she for instance practices in a particular discipline but we need the MMC to come forth into the 21st century and have an online searchable database of registered medical practitioners in this country (something like the
GMC UK)
Websites could be useful to patients and primary care practitioners trying to locate appropriate specialists for referral purposes. We still see too many people groping in the dark here not knowing whom to seek and where to go to for particular medical problems.
The MMR lists
Public and
Private hospitals and medical centres. If you know of a medical centre not listed, please send me
feedback.
I am also interested to hear what others think on this issue:
Should Doctors be allowed to advertise?
CSMU: The Saga continues
There has been no let up in the letter to the Press and further reports on this matter.
Two contrasting letters to Malaysiakini reflect the divergent opinions being expressed:
CSMU: Parents should sue MMCand
Medical council - keep the politicians at bayWho's right or wrong?
I believe the MMC should not remain silent and the best way to tackle the problelm is to be transparent and reveal in detail why the CSMU was derecognised, and the steps it took in the process.
The MMC must also demonstrate it acts consistently, and without any fear or favour, in the interest of safe guarding medical school standards.
On the matter of medical school entrance qualifications, I concur with Dr Cheah's concerns in
Flawed system?. I too am baffled, and no matter what excuse is given, I cannot fathom how Arts students were given No Objection Certificates (NOCs) for furthering their studies in medicine by the Higher Education Department.
Discuss CSMU Derecognition
Calling all Malaysian Medical Students
I realise that Malaysian Medical Students don't have a forum of their own. Yes, and some of you have even tried to sneak into
Dobbs but I'm afraid Dobbs is for doctors only.
However the MMR Forums now has a section catering for
Malaysian Medical students so you all are welcome to share your ideas there.
I have started off with a General section and sections for the various medical schools in and out of the country.
Please let me know if you want other sub-sections
For starters, I hope the CSMU students can participate as I would like to know the reall truth about the medical course. For instance, is it really in Russian or English?
Discuss further in MMR Forums
Feedback: Studying medicine
Annabel writes:
"i am a student who did my spm is 2003.i got B's in my chemistry and physics but i got a C in my biology and an A1 in mathematics. i am currently doing my south australian matriculation in a private college here. I am doing well in my programme now and i am really interested in doing medicine. i noe i can qualify very well for medicine now in my current programme.but will my biology results in my spm be a stumbling
block? will they look at my spm results even if i want to study in india or manipal and have done very well in my current matriculation
course?"
Well, I think the short answer is it depends on the entrance requirement of the medical school you are applying to.
Perhaps you can provide details on where you hope to study and other medical students, doctors or anyone who knows can help.
To facilitate exchange of information, please
Discuss further in the MMR Forumscatriena peter writes:
"hi sir,i am very interested about studying aboard.can you please reply my email regarding the prosedure on how to study aboard. the field which i interested is medical. i wish i can be a doctor one day. thank you very much sir."
Well catriena, it is not an easy answer as there are so many choices out there and the procedure and entrance requirements vary from school to school.
Why abroad? There are many options available now locally and you can check out the links from the
MMR Schools sectionPerhaps you could share where you wish to study and others can help you make your decision. I have created a Forum for pre-medical school discussion:
Discuss further in the MMR Forums
Site update: MMR Forums
I am introducing the
MMR Discussion Forums as an adjunct to the commenting system so that MMR readers can provide additional feedback and discuss issues at length and not be constrained by the Haloscan commenting system.
Registration is free so please head on to the :
I have put links to the Forum at the bottom of each MMR posting as well as a button link at the right and also the Feedback item of the menu bar at the top of this page.
It's experimental so please bear with it. If it proves popular, I shall add more categories/sections to it.
To start the ball rolling, I thought since there has been so many comments on the CSMU Derecognition issue, we could start a new thread in the MMR Forums on this topic. Haloscan comments will time out after sometime and it is a pity not to have a better record of some of your comments.
Discuss the CSMU Derecognition
Blonde Asians
I couldn't help noticing the
student blog with this pic of purple hair.
Yes. I am referring to the current phenomenon where alot of you people out there are dyeing your hair yellow, brown, red and various shades in-between.
Have any of you given thought to possible health risks?
There is some evidence that hair dyes are linked to autoimmune diseases like
Rheumatoid arthritis. There was earlier suspicion of a link to SLE but later studies have shown these not to be true (
1,
2)
What about cancer? Well the good news is so far it has been found that
Hair Dyes Unlikely to Cause CancerEvidence does not support the oft-cited increased risk of cancer among people who dye their hair -- but researchers say it is too soon to slam the door completely on the association.
The limited exoneration of hair dyes came from a meta-analysis of 79 case control and cohort studies that examined the relationship between personal use of hair dye and cancer. It was reported in the May 25 Journal of the American Medical Association by Bahi Takkouche M.D., Ph.D. and colleagues at the University of Santiago de Compostela.
The researchers did not include studies that examined a link between professionally applied hair dye and cancer risk.
Because hair dye is so ubiquitous -- about a third of women and 10% of men regularly dye their hair -- the Spanish team said that more research is needed to absolutely rule out a hair dye-cancer link. In particular, they added, more research is needed in hematopoietic cancers, where there was "evidence of increased risk in one or two studies." |
Well like cellphones, I guess the evidence points to "OK" usage so far but the jury is still out there and more studies and longer follow-up is required.
It is indeed a strange social trend where youngsters in Asia with lemming like behaviour continue to dye their hair. Why the need to feel "trendy" kids? Be individual lah. You don't have to "go with the flow".
God forbid we won't see an epidemic of rheumatoid arthritis 20 years down the line!
Discuss in the MMR ForumsAddendummiruL insists that his hair is not purple and that it is only a "lighting effect" :P
But note in the same
blog he admits that "I bleached my hair, yes I do. But I re-dye it to black, due to some pressure from public, but mainly because I'm returning back to Malaysia and can't face some critism. "
Yes, and Mom won't be too pleased about purple hair I'm sure ;)
Blogroll update: CSMU Student Blogs II
Added a couple more CSMU student blogs to the MMR blogroll:
ConTraDicTionZOf wishes and dreams(I wish wishes and dreams would change the background - kinda hard to read!)
both have RSS feeds so have included these in the
Malaysian Medical Student Blog AggregatorThanks YP and TS for the links!
Blogroll update: CSMU Student Blogs
Amidst all the controversy of the CSMU derecognition, I am sure some of you are wondering what life is like as a student in CSMU.
From the comments in MMR, we have found a CSMU student blogger,
Spunk-wwjd-.
Blogs sometimes give an interesting insight into campus life - something you can't find elsewhere. Anyway, Ian, you've been blogrolled by the MMR.... ;)
Also added the RSS feed to the
Malaysian Medical Student Blog AggregatorUpdate:Added another CSMU Blog -
Lifeinside, a Medical Student Diary. Thanks for the link - blogrolled in the MMR (but please turn on the RSS!)
And from your blog, I managed to ferret out some more medical student blogs :
Jack's cornerInfameMyreasonsAnandini
Right or wrong?
E has sent in this feedback:
I am no tattletale but I just can't stomach the ungratefullness of some of my friends’ actions. Hear me out and tell me what you think.
A couple of my friends were in town to do a visa. Incidentally, the were all from the same private medical school in Malaysia and like me is due to do their housemanship this year. The sickening thing is that being PSD scholarship students, the natural thing for them to do is to honour the agreement with PSD and work in Malaysia but no, they decide to do their housemanship in UK as they think they can’t survive doing their housemanship in Malaysia.
I was apalled to know that the whole batch of the graduating class is applying the visa stating that they are doing this so that it is easier for them to do post graduate studies (which to me is a bunch of bullshit excuses). Add this number to the many also graduating Malaysian students overseas who also refuse to come back and serve their housemanship in Malaysia for the very same (weak..) reason. We easily lose at least 200 students (yearly.. if this recurs).
Considering that the government paid more for their studies (as they were in a private institution or studing if foreign med schools) compared to us in public universities, their attitude to me is starkly sickening.
I myself wanted to work overseas (for experience sake) one day but to do housemanship there just because it’s easier over there is something cowardly. They are wasting taxpayers’ money and I can’t believe that the ministry actually give scholarships to
this ungrateful creatures. I remember back when they didn’get a place in Public universities, they were the ones who complained about the lack of scholarships for private students.
If they think they can’t survive housemanship in Malaysia, then why do you take up medicine in the first place. Where are all those ‘cita-cita murni untuk berkhidmat untuk bangsa dan negara’? Will taking the easier way out make you a good doctor? Is an overseas qualification makes you a good doctor?
Before signing off, I wanted to shout out for all the housemen in Malaysia. I am joining you real soon (am starting housemanship starting July 1st in Kuantan along with the rest of UKM Graduating Batch 2005). A couple of my good friends were bound for the East Malaysia (who were looking forward for their adventure of the lifetime).
Wished I could join you guys. The next two years (hopefully) would be quite a
journey to remember. Finally, good luck to all of you interns out there and all the best. |
Thanks for your feedback, E. Well, perhaps we shouldn't be so harsh on your fellow HOs,E. Post-grad training is a concern for one's future and perhaps they have a point in perceiving they have more opportunities to pursue their dreams if they were to go overseas. Some might be worried about being stuck in a local posting not of their choice and having difficulty getting into a Master's course or post-grad training scheme (perhaps others can share their experiences here). The MOH and the Ministry of Education (the Univerisyt Hospitals) at times are at loggerheads when it comes to MOs since the MOH may view MOs attending MMed programmes (fulltime) as "leaving" the MOH and creating a shortage for them. Unless there is a smoother mechanism to ensure rotation and training opportunities rural district postings will not be popular for this same reason.
Anyway congratulations once again to all graduating students of 2005 who are about to become or have become housemen.
If you haven't already, take sometime to read
Alan Alda’s speech to the P&S graduating class in 1979
Inspirational stuff for doctors-to-be.
Without fear or favour
Dr Inba, a respected anaesthetist, has written to Malaysiakini stating that the
Medical council must act without fear or favour. I thought he has summarised the concerns very nicely on why this must be so.
Many of my senior colleagues have expressed great concern with the deteriorating quality of candidates who are selected to do medicine at universities both locally as well as abroad. The list of worries is almost endless
* dubious entry qualifications,
* universities being forced to take a lot of candidates resulting in gross dilution of training,
* private universities being in the game just for the money,
* faculty members most of whom are part-time,
* the lowering of standards to enable a larger group to pass at the final exams and
* really poor attitude of candidates who seem to think that medicine is just another field to make money or get some status.
Add to this the intense pressure by parents to ensure that one their children must at all costs become a doctor, and you do not have a nice picture.
At the end of the day, the ultimate price will be paid by the public who will have to put up with ill-trained doctors who have very limited scholastic ability. Medicine has and always will be a process of life-long learning.
It does not end with a five- or six-year medical course as many seem to think. The safety of our public can only be ensured by an independent medical council which vets all undergraduate as well as postgraduate qualifications. |
The MMC should be like the Judiciary : an independent body which should not bow to political or any external pressure to bend any rules in the recognition of medical degrees. Take medical schools to task if they don't measure up to standards.
Update: Reply by Sad Parents:
As parents we cannot but more than 100% agree with Dr Inba's concerns.
So where are the checks & controls ???
1. Isnt that what the minimum entry qualifications set by MMC or Ministry meant to do?
2. Isnt that what regular monitoring, appraissal & audit of medical universities both local and overseas meant to do?
3. In the case of CMSU, these questions are still unanswered
4. Are we letting those over-zealous offcials at the ministry who approved approve the so-called arts students go scot free?? And penalise the qualified pre-med students who have registered and paid tens of thousands in fees etc.
5. CSMU is very strict on entry in that it WILL NOT admit any students without the approval certificate from the Malaysian Ministry of Higher Learning.
6. As for MMC, make public the findings of the short-coming of the CSMU and have these been communicated to the University or the Ukraine Embassy?
7.If at all true, should they be given a 1-2 year grace period to recitify the short-comings before de-recognising the university?
In the final analysis, it looks like all the reasons given for de-recognising CSMU has fallen flat in theface of MMC and the Ministry of HigherLearning.
The least MMC could do is to allow the pre-med students who have already registered to proceed for 2005 at least. |
ALS
"When you learn how to die, you learn how to live"
Morrie Schwartz
June 21 has come and gone this year but did you know that Global Day to commemorate
Amyotrophic Lateral Sclerosis/Motor Neurone Disease has been held every year since 1997?
It may be a rare disease but it affects people from every country and ehtnic origin, including Malaysians. In America, a famous baseball player,
Lou Gehrig, developed and died from ALS, and there the disease is also known as Lou Gehrig's disease.
You may be also familiar with the famous Physicist,
Stephen Hawking, who also has ALS and unusually, is a long-term survivor.
Some other famous people who suffered and died of ALS/MND include
David Niven and
Chairman Mao Ze DongMost patients are dead within a few years of diagnosis of this terrible, yet incurable neurological disease.
On a personal note, a family friend of mine has not long ago been diagnosed with ALS. It's even more frustrating when his family - wife and children - are all doctors, and knowing how difficult it is to treat, let alone talk of a cure. It is especially frustrating as the disease progresses you lose motor function due to progressive muscle wasting and weakness, and yet your mind remains intact. Simple chores like eating, swallowing and breathing eventually become difficult.
I am reminded of ALS too, as I am in the midst of reading a fascinating book by Mitch Albom (the author of the wonderful book Five People You Meet In Heaven) called
Tuesdays with Morrie.
To me, it is a stark reminder that medicine is all about trying to "heal where possible, to comfort always, and above all to avoid harm". I highly recommend this book to all medical students and doctors - it's a great read and an inspiring tale of the human spirit. For the busy souls or those who have forgotten the lost art of reading, Tuesdays with Morrie will screen on Astro's Hallmark Channel this Friday 24th June at 9pm (please check your Astro guide in case there are changes).
I can't locate information on a Malaysian ALS/Motor Neurone Disease support group or association. If anyone out there knows of one, please
email me. Thanks.
Feedback: History of Medicine in Malaysia
Nadia writes:
"Hello. i just need some help from any doctors who seem to know the history of medicine
in Malaysia or Malaya. from the research that i have done, medicine in Malaya [Malaysia and Singapore] started with the opening of King Edward VII College in Singapore. [now, known as National Uni. of Singapore]. i hope i am right. i was just wondering, before 1926 [the opening of KEVII college] were there any other schools offering medicine to the people of Malaya?"
To my knowledge, I believe you are correct. The first medical school in this region is the King Edward VII College in Singapore. Some famous alumni include our ex-PM Tun Dr. Mahathir and Tan Sri Dr Tan Chee Khoon.
The MMA has this article
Medical Education and Standards by Datuk Dr. V Thuraisingham. It states that King Edward VII COllege was established in 1905. The first medical school in Malaysia was established at UM in 1963.
While we are on the subject of recognition of medical schools, the same article mentions the GMC's derecognition of the UM Medical degree, an event which many see as a milestone in the decline of a venerable institution.
| The GMC was invited in 1977 by the University of Malaya to assess the progress of the medical schools. They submitted some constructive proposals because they were concerned that this school, previously highly acclaimed by them, was showing some potentially serious shortcomings. They advised that recognition be extended for another five years till 1982 on condition that remedial steps were to be carried out by the University authorities. In April 1984, the Overseas Committee of the GMC once again visited the University of Malaya and found that major deficiencies were evident and called for urgent remedial measures within a year; failing which the recognition of MBBS (Malaya) was to be withdrawn. |
While we talk of recognising or derecognising overseas medical schools, we need to constantly examine ourselves. What is the standing of Malaysian medical schools when measured by International standards? What is the current quality of our local medical school products? What is the current quality of our teaching staff?
I say to the powers-that-be : Shall we start with the "Man In The Mirror"?
I'm Starting With The Man In
The Mirror
I'm Asking Him To Change His
Ways
And No Message Could've
Been Any Clearer
If You Wanna Make The World
A Better Place
Take A Look At Yourself And
Then Make That . . .
Change!
- Michael Jackson
Medical School Standards: Staff-Student Ratios
One of the yardsticks in measuring the quality of medical education is the staff-student ratio. If this is too big, then the teaching quality will surely suffer. Medicine is one field where bed-side teaching is important and you cannot expect good quality teaching with huge numbers of students. You cannot learn medicine from lectures alone.
I was interested to read in
CRIMEAN WAR 2005: MPs trade barbs over medical council action , the Deputy Health Minister was quoted as saying
He said the number of Malaysian students had increased from a mere 53 to 1,366 in May this year, causing concern to the MMC.
"The desired lecturer-to-student ratio is one to four, but we got to know that it was one-to-eight at CSMU. |
What is the staff-student ratio in medical schools in Malaysia?
Take a look at the
list of schools we have which is ever expanding. Some are new and I seriously question the staff-student ratio as I suspect some of the smaller ones especially may have trouble recruiting enough faculty members.
Back in 2004, we highlighted this point.
I would like to quote again "Council of Medical Deans chairman Professor Dr Zabidi Azhar Hussin said some had vastly exceeded their capacity, with a 1:8 medical lecturer-student ratio when 1:6 was the accepted ceiling." Has the scenario changed? If it has not, then by the same yardstick, the eligibility for recognition of some of the local medical schools comes into question.
As I mentioned earlier I think the MMC should publically clarify in detail the method and criteria by which they accord recognition to medical schools locally and abroad, especially in the light of the controversy over the CSMU derecognition.
Links:
Minimum Essential Requirements and Standards in Medical EducationWHO Guidelines for Quality Assurance of Basic Medical Education in the Western Pacific Region (Adobe PDF format)
Liaison Committee on Medical Education (US)
Blogroll update
One of the doctor's blogs has been removed from the
Malaysian Doctors Blog Aggregator at his request.
Have added a new doctor blog, and this one from a very tech savvy doctor from Penang. Welcome aboard,
DocFiles!
Any other closet bloggers out there please let me know :)
CSMU feedback: letters from parents/students
Just got back from a 5 day break in a Northern State where the Internet connection has been quite poor so I have not been able to respond to a flood of feedback regarding the CSMU derocgnition issue. As you can see from the "comments" made to the last few postings, people have been quite "expressive" to say the least.
OK there are too many emails to publish here so I'll just reproduce a few.
Anand writes: "MMC reason doesn't make sense"
If the MMC has concern about the quality of training given in CSMU, why spare the students who already joined the college.they are still studying and will graduate from the same system of enrollment and teaching.
Is MMC going to jeopardise the welfare of patients in this country by allowing these students to treat us in the future?
Lets get the feedback from the CSMU administration regarding the current derecognition of their university.May be that will shed some light on what is really going on. |
I can't speak for the MMC and I don't know the exact reason for the 31 December 2005 cut-off date. Perhaps out of compassion?
ping writes:
| i would like to ask about the qualification to sit for the unscheduled malaysia qualification examination. Well, i am another wonderous and STRAY student in Ukraine medical university, not CSMU, but ternopil state medical university. i am the second year student here. if i still continue to study here, can i or am i eligible to sit for the qualification exam after my graduation? please give me advise and reply, lots of us over here are very helpless now. thanks!!! |
ping, I am surprised you went ahead with studies in the said medical school without clarifying this point. I would advise you to contact the MMC (address and phone contact published a few posts earlier) on this issue.
and one last email from Ms Tan:
We, parents and student of USMU are very disappointed of MMC action. the derecognised of the University announce at wrong timeing... they should have make know earlier , before June, so students, expecially of Pre-U, has the chance of transfering to other Moscow U. now , the time and places is too limited and the Moscow agent refused to take our application. as they have a lot of New, fresh student filling out the place very fast, unless we agree to re-do the pre-U and wasted one year of money and time in Ukraine...
Beside, the 1st year medical in Ukraine , the system will change to European system, next year, the Moscow University will not accept the transfer too....
It really hit hard for all those good student with many A, in SPM.. students, and they have the approval of the Education Minister to make sure they meet the requirement before accept into Ukraine....
It is very insensitive of the MMA (sic) to withdraw recognised out of the sudden before given them the chance/time for tranfering to other university so the when graduated , they will not face prejudice or find themself have problem in getting job in private sector.. |
Well Ms Tan, we do sympathise with the plight of qualified students who have been caught up in this. But I'll say it again, it's decision time now. You have to decide if one cuts losses now (both in terms of money and time) and apply to another University or go ahead knowing one has to sit for the Qualifying exam back in Malaysia.
The
list of Recognised Medical schools is very long and I am sure one can find a suitable alternative. The list changes from time to time and the one available in the MMR is current as of Sep 2004 so CSMU is still included in that list.
Again I implore potential medical students to contact the MMC on whether or not the medical school they are applying to is recognised by the MMC. Do not be misled into thinking that just because the JPA/PSD or Ministry of Education "recognises" the University, all is OK. Remember the license to practice medicine is issued by the MMC (not the MMA btw which is a doctors organisation)
I think a lot of the controversy stems from the lack of details available - what we read in the papers is all we know. Perhaps if the MMC could publish their criteria for recognition/derecognition of medical schools, that would appease the dissatisfied voices.
In the light of fairplay we would like to see the yardstick measuring quality of medical schools applied equally to all foreign and local medical schools but until and unless the yardstick is publically known, then it is difficult to comment further.
However if it is an issue of entry allowed to students with poor grades or Arts stream students then it is a serious matter. For the sake of public safety and safeguarding medical standards the MMC must stand firm. A medical degree has to be earned and not bought.
Dr Ismail Merican is indeed a senior physician and a man of integrity respected by the local medical community. I am glad to see him stand firm and upright in the face of those trying to politicise the issue.
Concerns about Russian/Ukrainian medical schools not new
Browsing through the
MMA website indicated that concerns about certain foreign medical schools is nothing new.
"CHEAP RUSSIAN MEDICAL SEATS WORRIES MALAYSIAN DOCTORS"
7th March 2003
The Ministry of Health and the MMA are aware that students without the minimum requirement are seeking admission into private medical colleges in Russia, Ukraine, Indonesia, India, China and Taiwan. In view of this, the MMA had a meeting with representatives from the Ministry of Health, foreign embassies such as Indonesia, China, India and Russia on 22nd April 2002. The MMA had advised the representatives to only issue visas to students wishing to pursue medical studies with the minimum requirement. Students ought to have at least Form Six or A-level qualifications.
Currently, there is no check system by the Ministry of Education and the MMA would like the Ministry of Education to play a major role to ensure only students with the essential requirement pursue their medical career only in recognized medical colleges. The MMA also warns students intending to pursue medical degree overseas that they should not be deceived by bogus and unauthorized recruiting agents. They are advised to check with the respective embassies. |
In another article on that same year,
PRIVATE MEDICAL EDUCATION OVERSEAS - ESPECIALLY RUSSIA AND UKRAINE
7th May 2003
The MMA is very concerned about the sudden influx of Malaysian students to pursue medical education overseas, despite the fact that there have been numerous articles in the print media stating that students without minimum requirements are attempting to pursue medical studies....cont... |
In 2003, the student statistics were :
a) 545 Malaysian students are pursuing Medicine in Crimea State Medical University in Ukraine
b) 150 Malaysian students are doing pre-medical courses
c) 12 Malaysian students have qualified and working in Malaysia. |
It appears that the student population has doubled since. However, it is difficult to judge what the actual lecturer:student ratios are, just by reviewing this figure.
Perhaps getting a view from the perspective of
CSMU may be prudent in our efforts at understanding the rationale for such a sudden derecognition. Afterall, they do have more than 90 years of history and experience in medical education that cannot be discounted.
Which university is next on the list? Are universities in China, Taiwan or Indonesia next on the list? Should there have been more warning issued prior to derecognising the university? Were officials from Malaysia sent to Ukraine to assess the actual situation rather than based on hearsay? Were the doctors trained in Ukraine that poor in quality? If they are, shouldn't the MMC be worried about the current 1000+ to-be doctors still there if they indeed were worried about patient care?
If indeed the current state at Crimea was that deplorable, there should be efforts in transferring the current batch of students to other universities. Is Malaysia to contend with poorly trained doctors at the expense of Malaysian patients in the future? The process of protecting the patients' interest does not end with just derecognising a university. There has to be a follow through plan to safeguard the interests of Malaysians, if indeed that was the initial intention.
Are Indonesian universities next? For a start, their courses are not run in English. Or will they escape the chopping block due to its geographical and political closeness to Malaysia?
The concerns about the quality of medical education is just, considering the number of medical schools now mushrooming in this country. However, there has to be proper justifications and accountability for their actions. There are unforseen repercussions with such a drastic action. Afterall, it is the government (Ministry of Higher Education) that initially gave the green light for these students to pursue their studies at these universities.
Perhaps everything will be clearer in the days to come. I hope that transparency will transpire in this saga to avoid any confusion with regards to the status of other foreign medical schools.
For the students
I've received several emails from students currently studying in CSMU expressing anxiety on their future.
Well, from what I gather, there's nothing to worry about since the derecognition does not apply to you as it is effective only for the entry after 31 December 2005.
What about those who still have not entered CSMU? Well, I'm afraid that one has to make a decision now to cut losses (on agent fees) and apply elsewhere or to go ahead but knowing one has to sit for the Unscheduled Universities examination upon return to Malaysia.
Take heart. If you are good enough, you should pass this exam which is really the final MBBS examination of local medical schools.
I have worked in Government hospitals and also served in a teaching hospital for over 14 years. What makes a good doctor is the individual. The medical training is important to set a good background but at the end of the day, it is the individual. We do need decent entrance qualifiations in order to ensure this. Good grades do not always ensure good doctors but bad grades are more likely to result in bad doctors than good grades.
Food for thought.
Recognition issues
After all this ruckus about the Crimea Medical School derecognition, let us sit back and reflect.
I personally think the MMC is to be applauded for their action. They are after all THE watchdog for what is the ultimate: maintaining standards of medical care in this country.
Note the DG's words:
| “The council will not compromise on patient's safety and shall always ensure that medical undergraduates have the required knowledge and skills to practice medicine safely,” said Ismail. |
I notice too there have been a number of comments about a "common qualifying exam" for all foreign graduates. Please note that Malaysia already has a qualifying Examination under the Medical Act 1971, called the Unscheduled Universities and Colleges Examination. It would be unreasonable to expect a examination for ALL foreign graduates so some system of recognition would be more practical. This is already practiced in UK, US and Australia for example. Those from recognised Universities need not sit for qualifying exams.
Local Medical graduates wishing to practice in UK and USA (e.g. for specialist training) have to sit for their equivalent qualifying examinations as our basic degrees are not recognised. The University of Malaya medical graduates up to a certain year (sometime in the mid-80's) are granted recognition by the GMC, UK so they don't have to sit for the PLAB examinations. One main reason for the subsequent derecognition of the UM medical degree by GMC, UK was the removal of English as the medium of instruction (this applies to the pre-clinical years only for the UM - clinical teaching is in English). If the GMC, UK is concerned that the practice of medicine would be affected by this, then the MMC is rightly concerned about our graduates studying abroad being instructed in a foreign language.
The medium of instruction in medical schools is important since English is the de facto language of medicine in this country (as it is in much of the world today for Science and Medicine). There may be fine Taiwanese and Japanese medical schools but graduates from these will still not be recognised and they would have to prove themselves proficient in the Unscheduled Universities Act.
The only thing you could criticise is why the apparent change in the MMC's thinking? Why the recognition-derecognition flip-flop as far as the CMS is concerned? Could it be because the MMC is alarmed about how this medical school has been recently taking in students, perhaps with profit on their minds and not qualifications? Could it have been because of a sudden surge in intake numbers? Something must have prompted the MMC to take action. Please note that in the Star report, it was stated that "dubious qualifications of students admitted for the institute’s medical studies, the difficulty of its medical graduates in using technical jargons in English and the possible strain on the quality of teaching due to the sudden increase in intake" were the reasons for the derecognition. It is quite possible the medical school and/or their agents were responsible for a recent surge in intake numbers and possible disregard for entrance qualifications that caused the MMC to take action.
I can't say much for the JPA/PSD in this issue. They are in no position to determine which medical school qualifies to be recognised as far as standards go. Only the MMC is qualified to do so. The JPA/PSD's interest is to find medical schools to place scholarship holders and I suspect cost issues play a major part in determining where to place students. So for potential medical students, please note that although the JPA/PSD says they "recognise" the medical school, please check on whether or not the MMC recognises the medical school concerned.
Crimea Medical University Derecognised - part IV
It is unbelievable that the Malaysian Medical Council can be so senseless. This drama of removing recognition from a medical university only portrays a council that is both incompetent and aloof. The reasons given for such a derecognition are preposterous.
Perhaps we should draw a comparison between Crimea State University and public universities. First is the dubious qualification of students permitted into the university. With public universities in Malaysia still relying on ethnic quotas, cronyism and programmes for the priviledged, as easy entry routes to desirable courses, I fail to see how Crimea could fare worse.
If the MMC really had the interest of patients at heart, then technical jargons in English is irrelevant. I am sure brilliant Japanese scientists may not even know simple English terms. They can be learned. What is important is how they practise medicine. Mind you, there are many local graduates and current local undergraduates that have a poor grasp of English and can hardly present a case in correct grammar.
Possible strain on teaching due to increased intake? That is ironic when local universities are themselves short of academic staff.
Perhaps a recent letter to Malaysiakni titled
"Medical Schools Ailing from "Know Who" syndrome" sums up the current situation well.
The MMC is at fault here. Why have they not ascertained the faults during the initial stages of evaluating the university? Mind you, this university was only recognised several years ago. Why the sudden change of heart? Should local universities then suffer the same fate?
Such hypocrisy nauseates me.
Crimea Medical University derecognised - part III
The NST has this report
Crimea degrees status in limboMore than 1,000 Malaysians studying at the Crimea State Medical University (CSMU) in Ukraine may be in limbo tomorrow.
Their fate depends on an announcement to be made by the Health Ministry on the possible withdrawal of recognition for medical programmes at CSMU.
A statement from the Health Ministry today said director-general Datuk Dr Ismail Merican will hold a Press conference tomorrow on the withdrawal of recognition for medical-based degrees from the university.
If recognition is withdrawn, Malaysian students pursuing pre-university and medical degrees there will face a dilemma.
It is possible, however, that the current batch of students may be exempted in the event recognition is withdrawn. About a third of the students are sponsored by Mara and Yayasan Selangor.
The Public Service Department has recognised the Bachelor of Medicine and Bachelor of Surgery degrees from CSMU since 2001, so graduates need not sit for a qualifying examination to practise in Malaysia upon graduation.
The medical degrees are also recognised by the Malaysian Medical Council |
Its inconsequential whether or not the PSD recognises the degree. The important bit is to understand that it is the Malaysian Medical Council which issues the "license to practice" medicine in the country - NOT the JPA/PSD. Without MMC recognition, a medical graduate cannot get a certificate of registration nor an annual practicising certificate which are compulsory in order to practice medicine in this country.
Update 16-6-2005 4:40 pm
The Star has this news update
No to medical courses from Ukraine's Crimea State Medical University Medical undergraduate programmes offered by the Crimea State Medical University in Ukraine will no longer be recognised.
Malaysian Medical Council president Datuk Dr Ismail Merican said it would be withdrawing its recognition of the programmes to any student being registered and admitted after Dec 31 this year.
Among the reasons cited for the withdrawal included the dubious qualifications of students admitted for the institute’s medical studies, the difficulty of its medical graduates in using technical jargons in English and the possible strain on the quality of teaching due to the sudden increase in intake. |
Crimea Medical University derecognised? part II
A Parent has written in to the MMR:
"We parents have just been hearing these rumours too.
Whatever the outcome, we trust the relevant authorities will act prudently in that adequate notice must be given if any changes are to be made ie changes to be effected from 2006 only.
It would be most unfair if the authorities suddenly pull the rug on all the intending students for 2005, who have paid thousands of ringgit in agency and registration fees to study in Crimea Medical University.
As a parent I checked with the Ministry of Higher Learning if CSMU was a recognised university before I proceeded to pay the fees and register my child.
It would be disasterous and loss of credibility if the authorities change the rules of the game half way through the game."
Well I guess these rumours have been circulating. To put an end to these rumours and uncertainty once and for all I hope the MMC and relevant authorities can come up with a public statement. Anyne who has managed to contact the MMC on this matter please
let me know and I'll add to this post.
Update 15-6-2005 7:55 pm
m.a. writes:
"I am one of the many parents with a lot of questions about this rumor. Latest news, after being alerted by my son in Ukraine, was the meeting in Malaysia ended this evening. They finally concluded that all students persuing the degree (or intake for 1st yr degree) within this year 2005, will be recognised. In other words, there is no more Pre Medic course for Ukraine. Anyway, the above information is a 'hear say' info, so until we get a official annoucement, we cannot be sure of anything."
Update 16-6-2005 1:20 pm
latifbacho writes:
"I have just contacted one of the officer's incharge in JPA recognition Higher Learning Dept. He said at the moment JPA still recognised the University , there is no other university recognised by JPA in Ukraine other than CSMU.So, worried parents out there, don't listen to rumours or hear say. "
(Palmdoc: Recognition of Medical Degrees is accorded by the Malaysian Medical Council and not the JPA. I would wait to hear from someone who has contacted the MMC instead)
World Blood Donor Day
Yesterday, June 14 was
World Blood Donor day. Normally I would announce these events a bit earlier in the MMR but I seemed to have missed this one a day late - sorry :O
But did you know:
Eight out of ten people in the world do not have access to safe bloodWe should be lucky this is not the case in Malaysia.
But with HIV on the rise, and Malaysia at the
brink of an epidemic we cannot be too careful.
So have you donated blood yet?
Feedback: Comments wanted on On Call Hike
Saras from Medical Tribune has written in:
I am writing a news story on the recent hike in on-call allowance for government MOs, specialists & housemen.
Any government doctor out there would like to comment?
Well here's you chance folks. Any Government doctors please post comments here for Saras to take note.
Saras might also want to take note that the MMR broke the news on 26 May and we posted it
here - there were 10 comments for that particular post.
Feedback: Crimea University derecognised?
syed asifi writes:
hie...i get some rumours that crimea state medical university already direcognized by our government recently..is that true...and what will happen for those who are studying
there right now?so i would like to know is there any university in ukraine will be recognize soon by our government?thank you in advance.
Well Syed, I haven't heard of this and I don't really know if this is true or just a rumour.
The only "list" of recognised medical schools obtained from the Malaysian Medical Council by the MMR is
this one which is current as of September 2004.
If you browse the list, the only medical school recognised in Ukraine is the Crimea State Medical University.
It is of course the MMC's perogative to delist any medical school if they find it not up to par.
I suggest if one is affected, or is keen to know the latest status, to personally write or call up the MMC rather than listen to rumours. Their contact is:
Majlis Perubatan Malaysia
Kementerian Kesihatan Malaysia
Aras 2, Blok E1, Parcel E
Pusat Pentadbiran Kerajaan Persekutuan
Wilayah Persekutuan Putrajaya
62518 Putrajaya
Tel: 603-88831400
There is no working email contact AFAIK (how I wish they had!)
Please post
feedback or comments to this post if anyone knows more details.
No epidemic but healthcare shortfalls exposed
From The Star,
Health director: Common illnesses killed orang asli kids
CAMERON HIGHLANDS: The deaths of five orang asli children in three settlements here last month were not due to any outbreak, Pahang Health Department director Dr Hasan Abdul Rahman said.
“The cases are not related to each other and they did not die of any mysterious disease, but due to common illnesses. These were isolated cases,” he added.
Commenting on news reports on the deaths of the children, who included an eight-month-old baby, Dr Hasan said two of them had sought medical treatment at a private clinic a week before they died.
“They were diagnosed with bronchopneumonia, and being a mild infection the clinic doctor felt there was no need to refer them to the hospital,” he added.
In the other three cases, Dr Hasan said two children had a history of suffering from diarrhoea while the other had fever and fits.
Dr Hasan said all the children, who lived in the Pos Leryar, Pos Rantau and Cheros settlements, died at home.
The water in the three settlements also tested negative for bacteria and viruses, he added. |
Perhaps it was a relief for many in public health that there was indeed no correlation between the deaths among orang asli children. However,the efforts to prove the absence of an epidemic only exposed the poor level of healthcare provided to these communities. The headline itself speaks volumes. Common illnesses? Indeed common illnesses should not have led to the deaths of these children.
Even the first case has evidently been poorly managed. How can a bronchopneumonia in an eight month old baby be a mild infection? I felt that the doctor in this case is to be faulted for not recognising the signs of a severe respiratory illness in this child and the ensuing failure to refer.
The history for the rest of the cases are vague. Unfortunately when children are dying of diarrhoea and fever, alarm bells should ring as to the level of healthcare provided and the extent of healthcare education received among these communities.
The Health Director in Pahang should not be satisfied with the absence of an epidemic. It is quite clear that something is wrong and concrete actions need to be taken to avert a more serious catastrophe in the future.
Feedback: Lapband surgery
wannaslim writes: I would like to know if my BMI is 21, weight 58kg, height 166cm. I look really fat. Can I go for the LAP BAND SURGERY? Do u have any idea about the cost of this surgery in Malaysia? Thanks for your time.
Dear wannaslim,
First of all a BMI if 21 is fine.
BMI as applied to we Asians has undergone a
Revision of BMI Cut-offs for AsiansTo summarise:
27.5 and above: High Risk (Obese)
23 – 27.4 : Moderate Risk (Overweight)
18.5 – 22.9 : Low Risk (Healthy range)
Below 18.5 : Risk of nutritional deficiency diseases and osteoporosis (Underweight)
Lapband surgery was mentioned in
Obesity becoming a huge problem. I would say diet and regular excercise is still the best way to go. Surgery is only a last resort for the obese. And once again a BMI of 21 is absolutely fine.
And for those of you wondering what is BMI and how to calculate it, you can go to
this site which has an online calculator too.
Feedback: Medic Alert Malaysia
Linda writes: I need to download the registration form from the above organization but
unfortunately the web page is unavailable. TQ
Linda, you are right. The
Medic Alert Malaysia website, which is hosted on UMMC is giving a 404 (file not found). Looks like the UMMC webmaster is sleeping again!
I have previously
tested the Medic Alert Malaysia system and found that it is far from satisfactory.
I suggest you call them up or write to them . I would be interested if you to know if you get good service or otherwise from them.
Their contact is:
MedicAlert Foundation Malaysia
c/o University Malaya Medical Centre, Jln Universiti, 59100 KL.
Tel 03-7957 5111.
Good luck.
Feedback: Biotechnology policy
Gwen writes: I'm Gwen and I am currently doing a research on the National Biotechnology Policy which was release by the PM on 28 April 2005. Is there any link/ place that I can get hold of the policy? Thanks. Appreciate it a lot.
I don't have the links in the MMR, but you know what?
Google is your friend!
Seeking a better public-private interaction
From Bernama,
Government Hospitals May Not Accept Patients From Private Hospitals
TEMERLOH, June 9 (Bernama) -- The Health Ministry may cease the practice of government hospitals accepting patients from private hospitals for post-surgery treatment.
Minister Datuk Dr Chua Soi Lek said the co-operation between government and private hospitals, established on mutual understanding and on humanitarian grounds, had long existed.
He added that it was unfair to put the blame on government hospitals if patients from private hospitals who were brought there died.
cont.... |
Is it ever possible for Government Hospitals to reject referrals from a private center? I fail to see how this could ever be implemented. This proposal has arisen due to a recent incident where a high risk operation was performed on a patient without first ensuring the availability of adequate post surgical care, and in this case, requiring ICU care. This patient was then referred to a government hospital in a critical condition. I guess many of the doctors in government services can relate to personal experiences involving such scenarios.
It is easy to put blame on private hospitals or even the families for such a predicament but I strongly believe that there is a serious flaw in our healthcare system. It is currently fragmented resulting in inefficient utilisation of facilities and human resources. Instead of instigating a greater rift between public and private hospitals, we should be working at integrating both these entities. There should be a better mechanism in place to enable a better communication between hospitals. I believe the burden on public hospitals can also be lightened by such a co-operation.
Similarly, as pointed out by Palmdoc in a previous post, there should be greater co-operation on the educational front as well. Depending on a depleting academia at public universities alone may not be wise if we are to maintain a high quality of education. However, archaic and naive mentalities have resulted in the lack of humility in recognising one's shortfalls as classically displayed by the Gomez saga recently. Such short-sightedness has certainly stunted potential developments in many areas.
Perhaps a 2-tier system may not be a good solution in a country where the divide between the rich and poor is still apparent. Will the National Healthcare Financing Scheme address this public-private discord? Bridging the differences can be challenging but a necessary move if we are to arrest the increasing stresses on government-run healthcare facilities due to high patient loads and a resulting lack of manpower and facilities.
PSD Scholarship Dilemma
The Public Services Department is currently embroiled in a controversy involving the award of educational scholarships for top scorers. Based on track record, Government scholarships have not always been awarded based on merit alone but influenced by politics and cronyism.
In a report by The NST,
Four top SPM scorers denied PSD scholarships
GEORGE TOWN, PENANG, Wed.
Puzzled, perplexed, but mostly outraged.
Pos Malaysia That’s how many feel about the Public Service Department’s rejection of the scholarship applications of four of the nation’s top Sijil Pelajaran Malaysia scorers.
Ng Ee Liang, who obtained 13 A1s, as did Desmond Chee and Teoh Wan Ying, is wondering what to do next as he had hoped to do medicine on a PSD scholarship. cont.. |
In an attempt at defending their position, the PSD has tried to explain that stiff competition for their scholarships has resulted in top scorers being sidelined as highlighted in the report below...
From The Star,
PSD: Half-a-point can make or break
BY SIM LEOI LEOI
PUTRAJAYA: Even a half-point matters when students apply for the prestigious Public Services Department scholarships, especially in competitive courses like medicine.
PSD public relations officer Hasniah Rashid said applicants were allotted points according to their academic achievement in the SPM as well as their extra-curricular activities, family background and performance during interviews with the department.
“Sometimes, it’s just a half-point difference in their total score. It’s not because they failed in their applications.
“However, due to fierce competition, particularly for medicine, there will be those who won’t be awarded the scholarships,” she said in an interview here yesterday. cont... |
I have serious doubts that the PSD has offered scholarships to all truly deserving individuals. The PSD's claims are weakly supported by vague statistics and very general comments. The selection criteria and the identities of students are shrouded in secrecy. I would challenge the PSD to release all information regarding the recipients of their scholarships and the reasons for their selection, for the public to digest. After all, it is the taxpayers that are indirectly funding these students. There are many recipients that we are aware of, that have not met the "strict" criterias mentioned but were offered full scholarships. Being truthful and forthcoming about the existence of racial quotas and cronyism may lend some closure to the brilliant students that have been rejected.
Public Private Interaction
Dr. J Veight writes in Malaysiakini that
Public, private medical sectors need to interact .
He makes reference (somewhat disconnected I think) to the Gomez affair, but I think he has hit the correct button when he says:
"Similarly frustrating push factors have created an internal drain of critical medical expertise from teaching institutions and government hospitals to the private sector. A cursory glance at the names of medical faculty deans and heads of medical departments throughout the country will confirm the claim. "
"Academically sequestered in private hospitals, private doctors are locked in to a system of ‘cari makan’ medical practice and have effectively been denied the opportunity to train the next generations of physicians. This is a waste and a shame. Medical training after all derives much from the model of apprenticeship and mentoring relationships."
Alright. I work in a private hospital. I see in my midst a tremendous pool of senior very experienced colleagues, many of whom have served in the Universities or Public hospitals in their capacity as senior consultants, heads of department and what-not. They are content with their private practice today as they "cari makan" but it is indeed a shame that they are no longer involved in the training of our young doctors. Who are are young doctors being exposed to in their training years? In the long run will the system suffer because they are being exposed to less experienced staff or in some cases a very short staffed situation?
"These trainees are the future doctors that one day will be delivering our babies, operating on our prostates and helping to keep us going till full life-expectancy years are reached. "
I do believe that in some situations, trainees could get "attachments" with senior colleagues in private practice to gain more experience. Perhaps we should not be stuck with the idea that training post-graduates should only be limited to public or university hospitals. Will the mind-set change? I think it can but will take more than a generation...
MMBA Update
I have been slowly updating the Malaysian Medical Blog Aggregator with new feeds. I am particular interested to fish out more doctor blogs from you guys/gals. I added
DocMac and just today I checked out the
Catholic Doctors' Association of Malaysia. I am aware this is a society website but this one is unique since it uses Blogger to power their updates. As it is in fact a blog and their commentaries are quite interesting from the Catholic viewpoint I have added them to the:
Malaysian Medical Blog Aggregator (Doctors) Anymore out there?
To return or not to return...
....that is the question.
I am referring to Malaysian medical undergraduates studying abroad, and contemplating if they should stay on to complete post-graduate training and specialisation prior to returning to Malaysia. Or should they return first to Malaysia where they could serve out their compulsory service first and go for higher training either locally or abroad?
Well, its a touchy issue and I am sure the Government would like all medical students to return early.
Ida Bakar in Malaysiakini feels vindicated as the
Gomez saga proves doctors right in not returning .
I think Ida has a point as I sometimes see potential wasted and snuffed out by the local system. Talent tends to flourish abroad. Why? The post-graduate system abroad is more mature and there are lots more opportunities. Lets face it, with a public health system short in many critical areas like neurosurgey, transplantation and what-not, no amount of "chest beating" and "patriotism" is going to change the fact that post-graduate training in areas where senior personnel are in short supply will be sub-standard or at least not in par with some overseas centres.
If the Government is serious in investing in human capital, then we have to invest in this not only in terms of local training but overseas training with truly merit based scholarships for young doctors with good potential. That's not all. The whole system must be revamped with adequate remuneration and other incentives to keep the trained and skilled persons in public service otherwise all this training will go to waste.
ICU shortage
From the
NST,
Lying in coma: 'Red tape to blame'
Alina Simon
SUNGAI PETANI, KEDAH, Mon.
Bureaucratic red tape at a hospital is being blamed for an accident victim lying in a coma at the Sungai Petani Hospital. cont... |
Shortage of ICU beds have been an inherent problem in this country. From the lack of beds to the lack of interest in intensive care medicine among doctors and nurses have led to the less than desirable condition of ICU care. The highlighted story above only represent the tip of an iceberg. There are many cases in regular medical wards that are deprived of ICU care due to the lack of beds and thus a much stricter criteria for ICU admission. With ventilated patients in regular wards with one nurse having to take care of 4 sick patients (in UMMC), is indeed undesirable.
Perhaps the only solution is to expand the capacity of ICUs around Malaysia and provide training for potential candidates interested in ICU care. I also believe that "high dependency units (HDUs)" should be better staffed and equipped. These HDUs should also be dissociated from regular wards to allow more specialised care and attention. If not, they are often diluted and burdened by chores of everyday regular ward work.
Perhaps
this article from the MMA lends a better perspective of ICU care..
Needle exchange programs: A crossroad?
There has been much hype surrounding the recent announcement by the Ministry of Health to approve a programme intended to decrease the incidence of HIV infection especially among injecting drug abusers. It was indeed a bold move that many thought was unimaginable in a society not well known for its liberal thoughts. There are of course advocates and sceptics alike. This issue traverses all levels of society and involves complex issues that are debatable, with clearly no resolve even in developed countries. It is not a simple public health measure.
It is important to be non-judgemental when looking at this issue of needle exchange programmes. Even the most pious ones, will have to acknowledge that something must be done to stem the tide of HIV/AIDS infections, for which injecting drug abusers form the largest fraction. Education and religious fervour should no doubt remain the most important counter measure against HIV/AIDS. However, being realistic that education takes time and is a slow continous process, should arouse us to find a quicker solution to avoid new infections in the interim period.
There is little doubt that needle exchange programmes are a huge success in many countries. Many miscontrue this programme as an "approval" for drug abusers. However, with the implementation of this programme we can not only monitor drug abusers but also offer them help in the form of counselling and medications eg methadone. Hopefully in this way , we can draw injecting drug abusers from the shadows of backstreet lanes and thus the opportunity to offer them rehabilitation by choice rather than by force.
PEMADAM has been sceptical about this needle exchange programme. Being at the helm of the Pusat Serenti programme which has been dubbed a failure, they are still refusing to accept facts that there has to be a radical solution to a potential devastating epidemic of unimaginable proportions in the near future. There should be no political or religious interventions when tackling this global problem. It should be done for the sake of humanity.
Such programmes have always been strongly opposed by religious groups. Their hypocrisy at times can be nauseating. However, they play an important role in our battle against HIV/AIDS. From education to incorporating programmes to accomodate drug abusers and HIV positive individuals, much is hoped for.
Sexual promiscuity remains a centuries old problem that should be recognised as a threat to society. Providing condoms and teaching its proper usage is only apt in tandem with this needle exchange programme.
I truly applaud the Ministry of Health for making this bold move that I, myself have never imagined possible. I truly hope that this programme will achieve successes comparable with that of other countries. It is time we join forces rather than bicker among us. Time is of the essence.
Related stories
Free Needles And Condoms Less Expensive, Says Dr Chan 7th June 2005
Bernama'Abstinence alone not enough to fight AIDs'
Feedback: Grow Taller
wannabhappy writes:
I'm wondering if there is any safe grow taller programs/supplements? I'm quite short & am depressed on the height I'm currently having. Really wish if there's any way I can
increase my height.. I've found a product in the net, it is called Growth ENHANCER Plus . I'm not sure whether the contents of this supplement will bring any side effects?
I'm afraid products like what you came across will not increase your height. If they contain "vitamins, minerals and herbs", they are just food supplements. Unless specifics are available on exactly what they contain and how much are present, it is difficult to comment on side effects but if these supplements are within recommended limits, then the main side effect will be you have lost $$$ by a scammer.
Some links for you:
Scam Height Increase Or Caveat Emptor - Let the buyer bewareIf it sounds to good to be true...Is there a safe way for me to change my height?
20 tips to prevent medical errors
Doctors are human. We make mistakes. Most of the time they are minor but sometimes they can be disastrous.
There should be checks in the system to help minimise errors and they do exist.
However a very important part of the error checking system must begin with the patient.
The AHRQ has this simple checklist of
20 tips to prevent medical errors
All patients should read and print this out...
Blogroll update
Added 2 more medical student blogs as suggested by yyyap:
Rainbow's EndWaves2shoreI looked for Syndication (xml/rdf/rss) links on these blogs but I could not. I suspected that these might be automatically turned on without the blogger's knowledge and a bit of googling showed these up as a {blog url}/index.xml link for blogdrive.
So I have added the feeds to the
Medical Student Blog AggregatorThe sorting on the feeds is manual but what I'll do is move up those who update their pages regularly and move down those who don't...
Keep the links coming in folks!
Blogroll update
Added
jinkhang's blog to the Blogroll (listed in the right). Yup, another IMU student blogger and a KVPUGer. ;)
Malaysian Medical Blog Aggregator II
I have updated the Malaysian Medical Blog Aggregator so that you can now view:
All ,
Doctors or
Student blogs.
I'm still appealing to those who haven't made use of RSS to please
turn it on. RSS is really one efficient way to get more people to read your posts. Aggregators or news readers can read multiple sites at one go in much less time it takes to surf all the blogs you want to consume.
I would appreciate feedback on the Malaysian Medical Blog Aggregator project too. Thanks.
Malaysian Medical Blog Aggregator
I have been thinking of this sometime now, as I would like to glance thru all your medical blog updates (you do update your blog don't you?) and we need something like
Medlogs.com but a Malaysian version instead.
What this does is put together all the latest Malaysian Medical Blogger's postings in one page for your convenient browsing.
This requires that your Blog site has an
RSS feed.
Any Malaysian doctor or medical student who blogs is welcome to join in this endeavour.
I notice though that only some of you have turned on your RSS/XML/RDF/Syndication option - if you are using Blogger, you can turn it on in the Settings. For other blog systems please read the help manual which comes with the system.
Please let me know if you have a feed and want to include in the MMBA
There are minor bugs at the moment and the "More" link in each does not work.
In the meantime, please browse the
Malaysian Medical Blog Aggregator version 1.1Leave your comments or send me
feedbackUpdate:
Minor changes - the MMBA is now version 1.1. Added the shortcut to this in the Top Menu Bar of the MMR under the Professional category.
Feedback: Junk food
amielynn writes:
hi, i'm a lower form student that have been given a school project on junkfood..
i want to ask you about the content of the junk food and its effect to human.
i'm really really appreciate if you can help me in this case.
Well Amie, thank you for writing in.
What's junk food you might ask? Well that's what they
serve you in your school canteen ;)
Seriously amie, I am quite pleased to hear you have a project. That's an encouraging sign that our educational system has not entirely degenerated to rote learning or perhaps I am mistaken and you are not studying in a public school but a private one instead?
Anyway you should know that
Google is your friend. You should be able to come up with links to informative sites on Junk food for your project.
Some links for you
Wikipedia on Junk FoodWhat is Junk foodNo Junk FoodSmart Food, Junk FoodThat should be enough to get you started.....
