UK college upset over non-recognition of parallel pathway graduates

 

The Royal College of Surgeons of Edinburgh has a long relationship with Malaysia and has been involved in the training of cardiothoracic surgeons in the country since 2000, according to its president Rowan W Parks. (Wikipedia pic)

PETALING JAYA: The Malaysian Medical Council’s non-recognition of the Royal College of Surgeons of Edinburgh’s (RCSEd) cardiothoracic surgery parallel pathway programme goes against the principle of partnership and work undertaken at the request of the country’s health ministry, says RCSEd president Rowan W Parks.

In a letter to health minister Dzulkefly Ahmad, Parks said the decision by MMC has put excellent surgeons, who have been trained and assessed robustly, in an untenable, distressing and unfair position.

He said the RCSEd has a long relationship with Malaysia, having been involved in training the country’s cardiothoracic surgeons since 2000 when one of its top surgeons Pala Rajesh was invited by the National Heart Institute (IJN) to initiate and develop the video-assisted thoracoscopic surgery programme.

“The RCSEd was also invited by the health ministry, Academy of Medicine of Malaysia (AMM), and the Malaysian Association for Thoracic and Cardiovascular Surgery (MATCVS) to help develop a national training programme in cardiothoracic surgery for the country.

Rowan W Parks.

“We were made aware of a severe shortage of cardiothoracic surgeons in Malaysia and the absence of any structured training programme of an internationally acceptable standard to meet the needs of the population then,” Parks said in the letter sighted by FMT.

Following this, he said a memorandum of understanding (MoU) was signed in 2014 between AMM and RCSEd, endorsed by then health minister Dr S Subramaniam and then director-general Dr Noor Hisham Abdullah.

The MoU was to accredit and assure the quality of training centres in cardiothoracic surgery in Malaysia, and to develop a curriculum for the training of the surgeons.

Accreditation, quality assurance visits

Parks said the RCSEd was invited to accredit training centres for this purpose, adding that together with its top surgeons and ministry officials, they inspected five cardiothoracic units to accredit and assure their quality as training centres.

They were IJN, Serdang Hospital, Pulau Pinang Hospital, Sarawak Heart Centre, and Universiti Malaya Medical Centre.

In addition to this, further visits were made for this purpose to IJN, Universiti Teknologi Mara, Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia, Queen Elizabeth II Hospital in Kota Kinabalu, Sultanah Aminah Hospital in Johor Bahru, and Hospital Raja Perempuan Zainab II in Kota Bharu.

“Working in partnership with AMM, MATCVS and the ministry, RCSEd developed a curriculum for the cardiothoracic surgery parallel pathway training programme in Malaysia, which follows the UK intercollegiate surgical curriculum.

“The entry criteria, duration of training, formative assessments with work-based assessments, and annual reviews of competence and progression assessments follow the same criteria and standards as approved by the UK General Medical Council (GMC),” he said.

According to Parks, 32 candidates have entered the cardiothoracic surgery parallel pathway training programme, four of whom have completed their training, and another eight have successfully passed their exit examinations.

Stringent examinations

Park said candidates must successfully complete at least four years of higher specialist training in cardiothoracic surgery, and be signed off by their programme director, before being eligible to take the examination, as per the practice in the United Kingdom.

He added that the examination is of the same standard as the UK Intercollegiate Specialty Board examination in cardiothoracic surgery and the only exam used in Singapore and Hong Kong.

It comprises a written single best answer paper, which tests knowledge across the breath of the syllabus; a clinical examination section which includes clinical scenarios, communication, and patient engagement skills; and a viva examination which explores the depth of knowledge, international guidelines, and complication management, among others.

“Examiners are provided by RCSEd from the UK while senior surgeons from the region are also trained and appointed. Expertise with regards to standard setting, quality assurance, psychometrics and question bank are provided by RCSEd according to standards required by the GMC.

“Candidates who pass are awarded a Fellowship of the Royal College of Surgeons of Edinburgh in cardiothoracic surgery, a qualification which enables them to apply for specialist registration as cardiothoracic surgeons in the UK,” he said.

Long working relationship with Malaysia

Parks said RCSEd highly values its long working relationship with the health ministry, AMM and MATCVS in training cardiothoracic surgeons to the highest standards and quality.

He said they have also established a regional office in Kuala Lumpur, and also conduct training courses and examinations for surgeons and dentists.

“We award the Tuanku Mukhriz Travelling Fellowship annually to provide surgeons with greater experience and training in rural surgery in Malaysia. We hope to be able to continue these collaborative activities to increase the standards and quality of surgeons practicing in Malaysia,” he said. - FMT