Specialists’ fate up in the air

Skin Check Malaysia founder and medical director Dr Khoo Lee Seng says the MMC and the process of admissions into the NSR need to be more transparent.

PHYSICIANS who completed the Parallel Pathway Programme (PPP) but were denied entry to the National Specialist Register (NSR) include those who did their residency or training overseas.

Almost all private hospitals require their specialist practitioners to be on the NSR. Insurance companies also tend not to cover treatment by practitioners not on the NSR.

Qualified Malaysian medical specialists are in a quandary. Many have completed residency training programmes in countries such as the US, Canada, South America, Japan, Taiwan, Hong Kong and South Africa.

Although they passed the relevant exit examinations and have authenticated logbooks, they have been denied entry into the NSR because their qualifications do not appear on the MMC’s list of acceptable postgraduate qualifications.

Some qualifications which were on the MMC or NSR’s approved list previously, have been removed or restricted.

For example, the Fellow of the Royal College of Surgeons (FRCS) Surgery in General is only recognised up to 2000.

For the FRCS Glasgow in Ophthalmology, qualification obtained after 1999 and until May 2005 is only considered for recognition on a case-to-case basis. Those who qualified after 2005 are not recognised by the MMC for admission into the NSR.

For admission of plastic surgeons into the NSR, there was previously a clause that stated that applicants with unrecognised post-graduate qualifications would be assessed on a case-by-case basis and that the candidate should have completed three to five years of satisfactory clinical work after qualification.

In many cases, after applicants provided the MMC with authenticated copies of the degrees, diplomas, board certificates, surgical logbooks and references, the response has often been that the training was not “equivalent” to the local Masters training programme. Appeals do not work as the MMC’s decision seems to be final.

All applicants are at the mercy of the MMC committee, which makes the final decision as to whether this equivalence applies to them.

The clause on case-by-case decisions has since been removed, which means that that door has totally been shut.

What is more surprising is that NSR seems to be admitting some specialists who do not have the stipulated qualifications.

Several Malaysian specialists were granted NSR status after obtaining qualifications from Iraq, Belgium, and Taiwan, qualifications that were not on the NSR admission list.

What is perplexing is that this does not seem to jive when other candidates have received responses like: “The MMC cannot be expected to make an exception for the applicant, who does not possess a recognised postgraduate qualification, to be registered as a specialist, when the law applies equally to all applicants.”

Clearly, there seems to be something contradictory and amiss here.

The original objective of the NSR was to protect the public from specialists with dubious qualifications.

The worry now is if there is some underlying protectionist thinking with regard to admissions into the NSR or some other unexplainable behaviour.

The MMC and the process of admissions into the NSR need to be more transparent.

The system needs public scrutiny. To ensure that all specialists trained abroad receive justice and fair play, NSR admissions require genuine, objective peer reviews.

This article first appeared in Star Biz7 weekly edition.