stethoscopefor star2 cover saturday, aug 4, 2012
Who regulates and decides admission into medical schools in Malaysia?
Many young people want to become doctors, whether of their own volition or at the behest of their parents.
These days, there are more applications for entry to medical schools worldwide. For example, there were 24,765 applications in the United Kingdom, of which 8,765 were accepted in 2013. Malaysia is no different, but there are no published statistics.
This article is intended to provide information to address some of the misperceptions in recent media reports.
Medical education in Malaysia is regulated by different agencies. They include:
1. Education Ministry
The Education Ministry (MOE) has control over all local medical schools.
Public medical schools and their university hospitals are regulated and funded by the MOE.
Private medical schools, which are self-funded, are granted time-limited licences.
2. Health Ministry
Satisfactory completion of housemanship is a mandatory requirement for full registration by the Malaysian Medical Council (MMC).
The majority of such training is provided in the hospitals of the Health Ministry (MOH) and MOE, with a current training capacity of 5,000. Housemanship training in some advanced countries are acceptable to the MMC.
3. Malaysian Qualification Agency
The Malaysian Qualification Agency (MQA) requires all medical schools to comply with its qualification framework.
The accreditation standards for all professional courses have been established and are evaluated by the respective professional bodies.
Accreditation is time-limited, the maximum being five years.
4. Malaysian Medical Council
The MMC recommends to the Health Minister, the qualifications from medical schools that can be recognised. These qualifications are listed in the Second Schedule of the Medical Act.
Graduates from unrecognised medical schools have to pass the Medical Qualifying Examination before they can be registered.
Prior to the establishment of MQA in 2007, the MMC was accrediting medical schools, but since then, the function has been carried out by the MQA.
The MMC sets the professional standards for recognition. These standards are found in its guidelines, which were first adopted by the MMC in 1995, with subsequent revisions, and are based on the guidelines of the World Federation of Medical Education.
These guidelines are known to all local medical schools. Non-compliance will impact on the medical school’s recognition by the MMC.
The MMC recommends panels to the MQA for the accreditation of medical programmes. The panels submit their reports to the MMC, which makes its recommendations to MQA and MOE. Based on its capacity, which is dependent on the educational resources and teaching staff available, each medical school is set a maximum number of students it can admit for each academic year.
Only doctors who are fully registered with the MMC are permitted to practise independently.
In carrying out its functions, the MMC puts patient safety and quality of care first.
According to the 2013 MMC report, there were 30,057 annual practising certificates issued, of which 18,360 were for doctors in the public sector and 11,697 in the private sector.
There are currently 32 local medical schools, of which 11 are public and 21 private.
The Health Minister is reported to have stated there are 18,789 students in all years in local medical schools and an estimated 15,000 Malaysians studying medicine abroad.
This means that there will be an additional 30,000 doctors within the next five years, i.e. the number of doctors will double by 2018.
As medicine involves life and death for many patients, the quality of doctors is crucial. (www.thestar.com.my/Lifestyle/Health/2011/01/09/Quality-first-not-quantity).
Although high academic qualifications are an important criteria for admission to all medical schools, they are not the sole one.
The MMC, in its document “Minimum Qualifications for Entry Into A Medical Programme” (www.mmc.gov.my) states: “The practice of medicine requires the highest standards of professional and personal conduct, as well as professional competence. Although some students have attained the academic standards required, they will not be suitable to a career in medicine. It is in the interest of the public and such students that they should not gain admission, rather than to have to leave the course or the profession subsequently. It is the responsibility of the medical school to ensure that there are no particular circumstances that will impact upon an applicant’s fitness to practise upon graduation.”
The attributes of a good doctor that ensures patients’ trust includes competence, communication skills, respect for confidentiality, empathy, and focus on safe and quality care.
Many medical schools in advanced countries are now placing greater emphasis on the aptitude and attitude of prospective medical students, and not just examination results.
Admission into medical schools is solely vested in each individual medical school. In exercising this right, the medical school needs to comply with the requirements of MOE, MQA and MMC, as non-compliance will impact negatively on its licence, accreditation and recognition respectively.
The MMC has previously derecognised a local medical school for non-compliance. This is not unique to medicine as a similar situation occurred in another professional course.
There are different regulatory agencies involved in medical education. The MMC sets the professional standards for the recognition of a qualification. The MQA determines the accreditation status of a programme, and in doing so, relies on the professional input of the MMC.
The MOE grants the licence that permit a medical school to operate.
The MOE and MOH provides housemanship training that enables a person to obtain full registration from the MMC to practise.
It is important that all stakeholders are clear about the respective roles of the regulatory agencies so as to avoid any unnecessary confusion.
Dr Milton Lum is a member of the board of Medical Defence Malaysia. This article is not intended to replace, dictate or define evaluation by a qualified doctor. The views expressed do not represent that of any organisation the writer is associated with. For more information, email starhealth@thestar.com.my.
