Cardiothoracic specialist issue nothing to do with UiTM kerfuffle

 

From Dr S Subramaniam

It is unfortunate that students from Universiti Teknologi Mara (UiTM) have inadvertently been drawn into the cardiothoracic surgery training controversy, necessitating them to come out and protest against the possible inclusion of non-Bumiputera students into the university.

Let us be clear about one thing though: this whole fiasco has nothing to do with UiTM.

This whole issue is about the Malaysian Medical Council (MMC) and the recognition of the Fellowship of the Royal College of Surgeons of Edinburgh (FRCS Ed) cardiothoracic programme, not UiTM.

For some strange reason, some members of the MMC have decided not to accredit a programme which evolved through the initiative of the health ministry with the support of the the Malaysian Association for Thoracic and Cardiovascular Surgery (MATCVS), the Academy of Medicine, and Universiti Malaya.

The FRCS Ed programme is guided by training structures developed by the Malaysian Board of Cardiothoracic Surgery (MBCTS) in collaboration with the Royal College of Surgeons of Edinburgh, while trainees have been trained in some of the largest cardiothoracic centres in the country, including the National Heart Institute (IJN), while being supervised by some of the country’s leading cardiothoracic surgeons.

Furthermore, on Sept 15, 2018, the Royal College of Physicians of Edinburgh, the College of Surgeons of Malaysia, the College of Surgeons of Hong Kong, MATCVS and the Joint Committee of Specialist Training of Singapore signed a memorandum to conduct a quadripartite exit examination for the FRCS Ed cardiothoracic surgery programme.

Therefore, the standard of this examination is defined through the collaboration of a few geographic entities, and not only one.

The MBCTS would only award the certificate of completion of training (CCT) to those who have successfully completed the structured programme and passed the necessary examinations.

The MBCTS’s award of the CCT is meant to be an indicator to the National Specialist Register (NSR) to register the candidate as a cardiothoracic surgeon, having fulfilled all the requirements and training as required by the MBCTS.

Singapore and Hong Kong have recognised this qualification as being a registrable specialist qualification. They would not have done so if its standards were questionable.

It is distressing to note that the MMC, in a meeting in October 2023, ruled that this training programme was not recognised as it was not in the list of recognised qualifications of the council.

The MMC must realise that this programme was created with the support and blessings of the then health director-general with other relevant leading professional bodies in the country.

The trainees were taken into the programme in 2018 in the belief that they will become specialists at the end of the training. They were all from the public sector and were trained in hospitals within the public sector, including IJN.

It was ironic for a consultant from IJN to advise a few doctors who had completed their training to do a credit transfer programme through UiTM’s masters programme to enable them to eventually become cardiothoracic surgeons.

The UiTM programme was only started in 2020 and, understandably, it was for the purpose of training Bumiputera doctors to become cardiothoracic surgeons.

By suggesting that non-Malay doctors apply to UiTM for credit transfers and the subsequent accreditation, he was virtually kicking the hornets’ nest.

The subsequent debate that this suggestion invoked took an unfortunate racial twist and invited many unnecessary arguments.

The NSR and the list of recognised postgraduate qualifications are all under the purview of the MMC. It should take cognisant of and respect the work of all the organisations involved in drawing up the FRCS Ed programme and recognise these graduates as specialists.

The then health director-general, who was also the MMC chairman, said in 2014 that this programme was being drawn to meet the acute shortage of cardiothoracic surgeons in the country.

He represented the health ministry in giving these doctors the belief that when they were registered for the programme, they would become specialists at the end of their training. That trust must be upheld.

UiTM should not be used as a stop-gap measure to resolve this issue. The legal framework and charter of UiTM defines that it was set up to meet the educational requirements of the Bumiputeras.

Bringing UiTM into this will lead to opening a Pandora’s box that will ignite unnecessary racial sentiments which, in fact, are totally unrelated to the field of cardiothoracic surgery. There are many racial rhetorics going on as it is, so there is no need to add another one.

The health minister, the director-general, and MMC have sufficient powers among themselves to collectively resolve this issue.

I hope good sense can prevail and a positive decision can be made to end this stalemate.

The UiTM cardiothoracic training programme, by the very structure of the institution, will be training Bumiputera doctors in that field.

The FRCS Ed programme has been training both Bumiputeras and non-Bumiputeras. Closing that door would mean that many doctors who could be trained in that speciality will lose that opportunity. - FMT

Dr S Subramaniam is a former health minister.

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.