Unhealthy growth of medical schools
KUALA LUMPUR: With too many medical schools, lack of teaching staff and insufficient training facilities, Malaysia is in danger of producing sub-standard medical graduates.
Tan Sri Dr Abu Bakar Suleiman says every state now wants to have a medical school
Former director-general of health Tan Sri Dr Abu Bakar Suleiman said: "Too many medical schools have been allowed to be started in too short a time."
He said this could become a problem when the country produced thousands of doctors who may not be as good "as they could be".
"We don't want numbers. We want quality: quality of medical schools, quality of medical graduates, quality of post-graduates. What we should be doing is working hard to make sure our medical schools are of international standard."
Commenting on the mushrooming of medical schools and the low quality of medical graduates, Dr Abu Bakar, who was D-G of health from 1991 to 2001, said the the authorities needed to consider the country's health planning when setting up medical schools.
"During my time, we used to advise the Education Ministry (the authority for higher education before the setting up of the Higher Education Ministry) on the formation of new medical schools, based on the country's health planning needs.
"There was coordination in terms of what was needed and what was the production capacity.
"For example, whenever there was a request for a medical school to be formed, the ministry would enquire which hospital would be used for training. The prospective universities would come to us and we would discuss with them what they were going to do.
"We allocated hospitals to them so that they had facilities for training and clinical experience. Without that, they could not go to the ministry to consider their application. They had to consult the ministry before it could get the approval.
"That was how it was when universities such as Sheffield, International Medical University and Monash set up their medical schools. It was difficult to get a medical school licence then. But now it appears that this link between the Health Ministry and the Higher Education Ministry in terms of manpower needs is not there."
Dr Abu Bakar, who is now IMU president, said co-ordination between the authorities was important, otherwise, the process of educating doctorswould not be done in a way that met the standards of local and foreign universities.
"Too many public universities are also being built too quickly and this is not healthy. There are too many housemen now, so supervising them can be difficult. And we worry they may not get adequate training."
He said producing 20-odd medical schools in fewer than 10 years did not make sense, adding that there was a need for the authorities to justify the existence of these schools through evidence-based decision making.
"At present, every state wants to have a medical school. But is there a need? Some don't even have enough training hospitals."
Having too many medical schools also results in difficulties in recruiting academic staff, who are in short supply locally and abroad.
He said even IMU, which has been in the industry for 19 years, found it difficult to recruit the right staff, adding that although a doctor may be a specialist, he may not necessarily make a good academic.
"We need experienced people with academic management skills, curriculum planning, assessment, benchmarking and accreditation."
On the quality of students pursuing medical studies, Dr Abu Bakar said while good grades were important criteria for entry to medical schools, students should also have the aptitude and desire to serve the community.
"The essence of being a doctor is to serve. Just because you are a bright student doesn't make you a good doctor.
"You must have other attributes such as being interested in people, the desire to help others, patience, and the independence of thinking and learning,"
He added that he had come across cases of intelligent students not doing well in their medical exams because of a lack of interest.
"Some students graduate but they don't want to practise because they are not interested in medicine; they took it up only because of pressure from their parents."
Those intending to pursue medical studies, he added, should opt for local public and private medical schools, especially in terms of meeting the local needs, failing which they should consider medical schools in the Commonwealth countries or the United States, which have a similar healthcare system to Malaysia .
He advised them to avoid studying medicine in other countries where the healthcare system was different than that of Malaysia.
"If you send them to Russia or the Ukraine, they are trained to perform in the healthcare system of their host country, which is not similar to the system here. I have reservations about that. But that does not mean they cannot perform.
"And why do you need to send them to other places where they have to learn a different language? Why do you place such a huge burden on them? There are more than enough local programmes here for them."