Malaysia: Too many doctors, too few hospitals

Malaysia, a country with about 26 million populations, boosts of 24 medical schools now.

A decade ago, the number of medical schools is less than 10. But in just ten years time, the number has boosted to 24, with large increase in the private medical schools. If we estimate each medical school is able to produce 150 doctors each year, then Malaysia would be able to produce 3600 doctors. This is not inclusive of the doctors trained oversea, for example UK, Australia, New Zealand, India, Indonesia, Russia, Taiwan and even Ukraine.

Shall we clap our hands celebrating that the health quality is going to improve due to the smaller patients-to-doctor factor? Or shall we ring the alarm bell that our current health system is not able to digest and accommodate the sudden increase in numbers of medical graduates? Do we have enough teaching hospital, supervising senior doctors and even patients?

The list of medical schools is obtained from Dr. Hsu:

Public universities:

  • University of Malaya, Faculty of Medicine
  • Universiti Kebangsaan Malaysia, Faculty of Medicine
  • Universiti Sains Malaysia, School of Medical Sciences
  • Universiti Putra Malaysia, Faculty of Medicine and Health Sciences
  • Universiti Malaysia Sabah, School of Medicine
  • Universiti Malaysia Sarawak, Faculty of Medicine and Health Sciences
  • International Islamic University Malaysia, Kulliyyah of Medicine
  • Universiti Teknologi MARA, Faculty of Medicine
  • Universiti Sains Islam Malaysia, Faculty of Medicine & Health Sciences
  • Universiti Darul Iman,Faculty of Medicine

Private Universities and Colleges:

  • UCSI University, Faculty of Medical Sciences – School of Medicine
  • Monash University Malaysia, School of Medicine and Health Sciences
  • International Medical University, Faculty of Medicine
  • AIMST University, Faculty of Medicine and Health Sciences
  • Allianze College Of Medical Sciences, Faculty Of Medicine
  • Management and Science University, Faculty of Medicine
  • Cyberjaya University College of Medical Sciences, Faculty of Medicine
  • Royal College of Medicine Perak, School of Medicine
  • Melaka Manipal Medical College, School of Medicine
  • Penang Medical College, School of Medicine
  • MAHSA University College, Faculty of Medicine
  • Newcastle University Medicine Malaysia (NuMED)
  • Taylor’s University College, School of Medicine
  • UTAR

As a medical student, I am deeply concerned with this matter. Firstly, I am worried about the quality of training that I would receive during my internship. I read that certain department is overcrowded with students. Less tutoring from the supervisor, less hand on due to competition for patients. To some extent, the competency of the doctors is compromised.

Secondly, I am troubled with the possibility that new medical graduates may not get placement in the teaching hospital. Although the governments has promised to increase the number of teaching hospitals, this recruitment process is time consuming because it involves human resource training, facility improvement and national health budget.

From the other perspectives, the increase in number of medical graduates could bring some benefits. The current problem of hospitals insufficiency may just be a transitional. Once the necessary facilities are built, the health system would be able to accommodate the large increase in doctors. Well, this suggestion will only work if the government limit the license to establish new medical schools.

The private hospital and government hospital has vast difference in the working environment. The government hospital is notorious for long hours of working and overwork. With more doctors in supply, probably the workload per doctor could be reduced. This can create a more desirable working environment to retain the doctors in the public sector.

A larger number of government doctor also allow better distribution and mobilization. Due to tight competition in the urban area, more doctors will be willing to work at remote areas. The polyclinic and public health centres are still having shortage of doctors. This will improve the accessibility of health.

With more doctors, the government can also shift their attention from training more GP to training more specialists. Public health will probably receive more attention and hopefully we can see  the increase in the number of epidemiologist and public health officer. Maybe more doctors will opt to further their study to become medical researchers.

The above is just my suggestion. It may be too opportunistic and may have lots of flaws in the implementation. Nevertheless, I see this as a good start towards a more developed health care system in Malaysia. Enough of complaints about too many doctors and too few hospitals. Find the solution! Perhaps we can start by drafting plans to build more teaching hospital in the needed area.

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5 Responses to Malaysia: Too many doctors, too few hospitals

  1. Pingback: Disowned « In My Father's Footsteps

  2. Pingback: For Future Doctors: Shift Duty for Housemen? Part 2 « Pagalavan's Avatar

  3. Nav says:

    There are 33 med schools in Malaysia now. Even the UK with its 60 mil population only has 32.

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  5. George Tan says:

    Dear Sir / Madam

    Please consider circulating this opinion, the aim is to inform people , and hopefully enable them to carefully consider medical studies

    Recently the news has reported that malaysia currently has too many private medical colleges, too many
    young doctors..

    Many new medical graduates now will have to wait many months , sometimes up to a year
    before they will get a contract housemanship job .

    Housemanship jobs will be given on contract for 3 years and then , subject to satisfactory completion of
    housemanship the young doctor , may get a 2 year contract to do the 2 years compulsory service which is required
    for full MMC registration,

    Unlike previously , permanent employment with the govt & the ministry will not be guaranteed, but based on
    performance appraisals , reports, and reccomendations by the DG Ministry of health

    Recently 1000 of 5000, housemen have been reported to, not complete their housemanship , going missing in action
    because, they were not interested in medicine but were forced to study by their parents, disillusioned by the hard work,
    long hours, because they couldn’t handle the stress of a medical job, as well as the the scolding from their seniors

    Also it has been reported that of those who finally complete their housemanship, about 30 % have repeat a posting
    or get an extension because of unsatisfactory performance

    In addition , the keen competition, low prospect of being able to specialise (only about 5-10%), limited prospects of
    private general practice ( recently reported widespread gp clinic difficulties and closures),and the hignly likely
    prospect of unemployment, or underemployment or or employment in a different /lower professional level or
    in a different industry , individuals wishing to study medicine shoulder consider

    1 Are you brilliant- as the health care industry is knowledge based, values problem solving a, requires innovation and improvisation
    the average individual could survive in the past , but may find difficulty nowadays, as only the fittest survive.
    The average person may take longer to learn, be more often scolded, victimised, sidelined , stressed out, burnt out

    2 Can you cope with dissappointment Are you a kind , compassionate character willing to help the troubled,
    willing to work for next to nothing , ready to to give the needy a free meal wnen? where required

    3 Is there a back up plan- eg willing to accept a lower status job , help work in a family buisness

    4 Never, Never , Never take a big loan to pay high fees you cannot afford , This is stressful , painful and cruel to your family,
    good potential ,brilliant people have had to abandon specialist training because of socioeconomic reasons

    5 Do not be misled by education agents , Make sure , make sure that your qualification will be recognised, in the
    country you wish to work in and you will qualify for residence requirements , and that you have a realistically, a
    reasonable chance of being given a chance to get medical officer position

    6 Choose a medical college which/ with
    -reasonable fees, not for profit, run by established local Malaysian organisations eg UTAR, AMIST, Mannipal, IMU,Monash
    – a substantial faculty, with many experienced , staff members with full time appointments,

    7 Do not , Do not make the big , big mistake , Do not choose any medical college with/which
    – expensive fees , twinning programes linked to colleges overseas , or having preclicinal teaching overseas,
    – advertise , advertise excessively as excessive advertising chews up resources better used for teaching facilities eg library ,
    – charge fees of RM 500,000-00 but do not inform that the real cost , inclusive of the living expenses is about RM 1,200,000-00

    8 If in spite of the difficulties and difficult uncertain future of a medical career, you wish to study medicine then consider,
    a medical college with
    reasonable costs 250k – 350k
    recognised by Malaysian Medical Council
    full time academic staff , who have substantial track records in clinical service, teaching , research and publication

    9 Do not pay excessive amounts for medical college fees hoping that their degree is internationally recognised as claimed in adverts
    because the country you wish to get a job in may
    a) change the recognition , ie cease/ stop recognition of the degree in future eg as happened to one medical college
    b) not have a vacancy for a position at your stage of medical career , when you require one
    c) may only consider international medical graduates for temporary remote , rural jobs after which they need to pass difficult exams
    d) may only consider international medical graduates who qualify for permanent residence or citizenship

    10 Do not study medicine
    to emigrate
    become rich

    11 If a real internationally recognised programe desired , do the IMU partner medical school programe. Recently someone, graduated
    from a New Zweland University, through the IMU partner medical school [rograme, He could not get a housemanship job in NZ , but got
    one in S’Pore,

    Please feel free to edit or publish, Thank You

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