Malaysia - KL to drop some medical schools

The Malaysian government is looking to slash its list of approved overseas medical schools in an effort to address complaints that too many under-qualified doctors are joining its hospitals.

How many of the 375 recognised overseas medical schools will be dropped is not clear but Datuk Dr Hasan Abdul Rahman, the Health Ministry's director-general, has said the list will be "substantially shortened".

Some Malaysian doctors say as many as half the number of schools may be dropped.

The cuts will affect thousands of aspiring medical students who flock to cheap universities that made it to the approved list in the past decade such as some in South Asia and eastern Europe.

At that time, Malaysia faced a severe shortage of doctors and came under intense pressure from parents to increase the intake for medical students, especially in Malaysian universities.

The issue even took a political turn: When students with top results in the school-leaving examination (equivalent to Singapore's O levels) failed to make the cut in medicine, some non-Malay parents blamed it on racial discrimination.

As a result, the government quickly opened more medical schools in Malaysia, boosting the number from 10 to 24 between 2001 and 2010. And overseas medical schools recognised by the government grew from 210 in the 1970s to 375 today. The list includes the National University of Singapore.

About 4,000 to 5,000 Malaysians now become doctors every year.

This has given rise to a whole new set of problems. Hospitals complain they cannot cope with the deluge of trainee doctors, or housemen, while standards have reportedly dropped.

"There are so many people wanting to do medicine for the wrong reasons and attitudes," said Dr Mary Cardosa, head of the Malaysian Medical Association which groups the country's doctors. "Lots of young doctors may not know what they're getting into."

The 39 training hospitals nationwide have struggled to cope with the numbers, leaving many of these new graduates without adequate supervision or opportunity to learn.

The number of house officers soared 272 per cent from 2,297 in 2008 to more than 6,200 in 2010, according to the Health Ministry.

The accreditation process of overseas schools will also be made be more stringent, Dr Hasan told The Sun daily earlier this month.

"If a university is given full accreditation, we will visit the university every five years," he said. "If there are any discrepancies or doubts as to its quality, the frequency will be increased to once in two years."

Without naming any specific overseas universities, several local doctors told The Straits Times that some medical graduates from Russia, Ukraine, Indonesia and India lacked core knowledge.

In 2005, the Malaysian Medical Council ended its recognition of the Crimea State Medical University in Ukraine for accepting even students with an arts background. The move caused an uproar among parents, students and the opposition because the university had already taken in 1,100 Malaysians.

A head of infectious diseases in a government hospital said the quality of housemen had dropped.

"Yes, in my experience, I can tell you that the average houseman today is not as good as those 15 years ago," he said on condition of anonymity.

Many medical students study in these lesser-known universities because they are often much cheaper and easier to enter than those in Britain, the United States and Australia.

Compared to the US, where a medical course can cost about RM700,000 (US$184,000), it costs only about RM100,000 to study in some of the cheaper overseas colleges.

But Dr Parameswaran Ramasamy, a clinical psychologist with his own practice, does not think dropping the number of recognised overseas universities en masse is the answer. He said it would remove educational opportunities for aspiring doctors here.

"Whether they recognise these universities or not is not the right answer," he said. "They need to put in stricter criteria for entry and look at the graduates' soft skills training."

Malaysia is still short of the World Health Organisation recommendation of one doctor to 600 Malaysians, and aims to reach that goal by 2015. It now has one doctor for every 900 people. In the remote areas of Sabah and Sarawak, there is only one doctor per 2,000 people.

Lester Kong

The Straits Times

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