Call for competent doctors should start with meritocracy in medical intakes

 

The decorum displayed in the Dewan Rakyat by MPs last week when debating the all-important Medical (Amendment) Bill 2024 was outstanding. Those debating the matter were allowed to speak their minds freely with very little interruption from others.

The bill empowers the Malaysian Medical Council (MMC) to recognise training institutions and the qualifications they award for inclusion on the national specialist register.

It also seeks to make the health ministry an institution capable of providing specialised training. With this, some of the specialist qualifications obtained via the ministry’s parallel pathway programme can now been included on the list.

The bill was passed with a resounding voice vote, finally bringing an end to the fierce debate between the proponents of the parallel pathway programmes and its opponents.

What struck many was the orderliness in the way MPs spoke and conveyed their thoughts. This was a far cry from the usual shouting matches, name calling and thuggish displays in the august house.

Only once did we see an argument in a raised voice, but even that was done with some civility. Arau MP Shahidan Kassim, a former minister, crossed swords with health minister Dzulkefly Ahmad, saying it may not be healthy to recognise either the MMC or the minister absolutely.

He pointed in particular to the proposed amendments to Section 14B(2), which will empower the health minister to register specialist doctors on the MMC’s recommendation if satisfied that the applicant has a comparable qualification or specialised training of special value to the country.

Shahidan said such powers would be appropriate if the minister was a medical expert, which was not always the case. He said the power to register specialists should only be vested in medical professionals.

MPs repeatedly focused on the need for quality in the medical profession, given that doctors deal with lives.

PAS’s Permatang Pauh MP Muhammad Fawwaz Jan read a well-prepared speech calmly, saying nothing in the amendment should compromise the quality of doctors as the rakyat’s lives are at stake.

He agreed the amendments would speed up the appointment of specialists but questioned the need to 

rush

 through it, saying they must be carefully managed so as not to affect the quality of specialists.

His call was a refreshing one, given that he normally grabs the headlines for comments that touch on race and religion.

Quality healthcare is not something that can be compromised. It’s simply not negotiable.

This is where it gets tricky. There have been numerous complaints lately of medical negligence, long waiting periods and the incompetence of medical and paramedical staff.

Some of the blame may be attributed to a shortage of specialists and medical officers, but there are also complaints about questionable decisions which suggest a lack of competence.

The problem may also lie with medical schools operating here and abroad. We have a total of 32 medical colleges in the country – 21 private and 11 public schools.

While government universities use matriculation and Sijil Tinggi Persekolahan Malaysia (STPM) exam results as entry requirements, private colleges locally and abroad accept foundation programmes to enter medical schools. These students must secure a minimum B grade for additional mathematics and the three science subjects in their Sijil Pelajaran Malaysia (SPM) examinations.

Those studying abroad privately are also subjected to an additional requirement. They must obtain a 

no objection

 certificate from the public services department by proving that they have obtained the prerequisite minimum B grades in the four subjects.

Let’s face it, to have quality medical officers and specialists, there is a need to raise the basic entry requirements to all medical schools.

There have been whispers on the quality of some foundation programmes in private colleges and medical schools. No one knows how often the higher education and health ministries audit these colleges.

The quota system in our public universities has also to some extent prevented the best brains in the country from entering medical schools.

Parents, too, are known to force their children into the field, resulting in a lack of interest and mediocrity.

That has seen many housemen and medical officers quit the profession altogether. It was reported last year that about 30% of the housemen quit without even completing their housemanship stint. That represents a colossal waste of time and money.

So, in short, to improve the quality of healthcare in the country, there is a need for a complete overhaul of how students are picked for medical schools both in the government and private universities.

One suggestion would be to raise the entry requirements into matriculation colleges and public and private universities.

Of course, doing away as much as possible with the unwritten racial quota system in public universities will also ensure that mediocre students do not slip through to become doctors. This suggestion will surely see a heated reaction from nationalists but nothing should come in the way of producing the best doctors.

Perhaps the government should also consider a common aptitude examination for all students intending to study medicine after their SPM to get only the best to enter medical schools and prevent disinterested doctors from serving the rakyat.

Malaysians will have no reason to object if only the best and those with the right aptitude become doctors. - FMT

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