Study hard and be let down – again

It’s a perennial problem – more top scorers than places at public universities for medicine, dentistry and pharmacy. The cheapest route to these degrees is fraught with uncertainties and heartache.

IT costs the government about RM70,000 a year to train a medical student at a public university. That works out to RM350,000 for a five-year course.

But a student who gains a place at one of the dozen public institutions offering medicine forks out less than RM20,000 in total tuition fees; the rest is subsidised by the Government.

Does it not then make sense for any brilliant student whose family cannot afford the RM350,000 to RM1mil for a private or foreign degree to spend two years doing Form Six and sitting for the STPM?

Everyone knows that the STPM or Malaysian Higher School Certificate is seriously tough, more difficult to excel in than the internally examined Matriculation offered mainly at matriculation colleges where 90% of the students are bumiputra.

That is why every student who slogs away and scores the maximum CGPA of 4.0 feels “cheated” of the cheapest route to a medical degree when they fail to secure a place at a public university.

This applies to other critical courses like dentistry, pharmacy and certain branches of engineering too. When even those with a CGPA (Cumulative Grade Point Average) of 4.0 don’t make the grade for medicine, they will be “dumbed down” to take up their second and third choices of the critical courses; and in the process, raise the cut-off point for these courses.

The spillover effect will be felt by those with lower CGPA scores who had hedged their bets by applying for dentistry and pharmacy.

This translates to more applicants crying foul because they didn’t get their course of choice despite having almost perfect scores.

There is also a perceived lack of transparency in the information made available for “strategic” application on the part of STPM students.

For one, while STPM results are made public, matriculation results are not. (Last year, there were 83,000 Form Six and 26,000 matriculation students.)

As an STPM candidate, you don’t know where you stand against the others competing for the limited places. In 2004, for example, when “Medic blues” (same issue of top scorers not getting into medicine) made headlines, there were 527 STPM students with CGPA 4.0 but more than double (1,247) with the same grade via matriculation.

For STPM students who may take up to five subjects, their CGPA scores are calculated based on the best four subjects, including General Studies.

The results of students from both “streams” are merged into a master list for allocation of places in universities.

Perfect score students failing to get their preferred course – this year, some were offered nothing – is a perennial problem.

But it is more acute in a year when the STPM yields better results while the number of places remain static. A total of 442 who sat the exam last year scored 4.0 compared with 300 the year before.

Last week, Higher Education Department director-general Prof Datuk Dr Morshidi Sirat said in a statement that 41,573 of STPM, matriculation and Asasi (Centre for Foundation Studies) students were successful in gaining admission to 20 public institutions of higher learning.

According to UPU, the coordinating body for intake into public universities, on its Facebook page, there are more than 2,500 (including the 442 from STPM) applicants with a CGPA of 4.0, most of whom applied for competitive courses like medicine, dentistry and pharmacy.

But the number of places allocated for the three courses in all public universities is just 1,078 or less than half the number of perfect top scorers! Imagine the competition, what more for the 699 medical places. It’s 699, 119 and 260 respectively.

If this is an annual predicament, can’t more places be opened up at public and private institutions?

In terms of physical infrastructure, it is possible, although the intake is strictly guided by criteria set by the Malaysian Medical Council. Student-lecturer ratio must match the facilities provided.

But the problem lies in academic staffing and the limited places for clinical training at teaching hospitals.

If public universities are bursting at the seams, the same may not be the case at private universities.

If the Government subsidises a student’s tuition fees at a private university like it does in public universities, more places can definitely be made available.

What the country needs is “good financial modelling”, says Taylor’s University vice-chancellor and president Prof Datuk Dr Hassan Said.

Private institutions too would like to have top scorers enrolled in their medical courses and raise the competition among their students, making it a win-win situation.

Should supply meet demand?

That is a question the Health Ministry has to grapple with. Are there more students who want to be doctors than the country needs?

Currently, doctor-patient ratio in Malaysia is 1:800. We are expected to achieve the 1:600 ratio recommended by the World Health Organisation (WHO) by 2015.

With the 3,500 doctors (via public and private institutions) that the country is producing annually, the Health Ministry expects to hit doctor patient ratio of 1:400 by 2020, which will exceed WHO’s recommendation.

Doctor wannabes should bear in mind that getting a job may not be as easy in future although the country still lacks specialists.

For medicine, scoring 4.0 may be the main hurdle but it is only the first hurdle. Participation in co-curricular activities also contributes 10% to the total points for entry into public universities.

Universities today want some say on who should join their most competitive course and put candidates through aptitude tests and interviews.

While there are calls for universities to do away with the “subjective” interviews, those in the medical faculties feel strongly that this is the most effective way to gain a snapshot of a candidate. Does he really want to be a doctor or is there parental pressure?

In private institutions like Monash University Sunway campus, an applicant has to go through four “mini” interviews – 10 minutes each with four interviewers separately.

Its head of the Jeffrey Cheah School of Medicines and Health Sciences Prof Datuk Dr Anuar Zaini Md Zain shares that the interviews are designed to be as objective and reliable as possible.

He says they are looking for the ability to communicate, empathise, work in a team, and have real expectations of the job.

“You need to be able to communicate and listen or you won’t be able to know your patient’s problem. In fact, the biggest complaint against doctors is that they don’t talk and can’t communicate.

“English proficiency is really important as teaching is mainly in that language, whether in clinical years or post-graduate training anywhere in the world,” says the former medical dean of Universiti Malaya.

Basically, interviews are not designed to fail an applicant but to help weed out the wrong candidates and reduce the attrition rate among medical students.

While it is costly for universities to conduct interviews for every applicant, it will be even costlier for them – and society in the long run – to train the wrong person.

> Twelve years ago, I wrote a comment on the problem of top STPM scorers not getting their course of choice and titled it “Study hard, come out on top and be let down”. Looks like little has changed. Feedback is welcome at

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