SPEECH FOR “ENTRY INTO POSTGRADUATE SURGICAL TRAINING COURSE” LECTURE HALL ASSC, UKM MEDICAL CENTRE
22nd NOVEMBER 2014

First and foremost, I would like to thank the organisers for coordinating this “Entry into postgraduate surgical training course”. This is such a beneficial starting point for those young doctors who are interested to pursue their career in surgical specialities in Malaysia. I hope all of you will gain a lot of tips and guides from this course.

Ladies and gentleman,

Rapid advances in medicine and surgery has invoked the necessity to develop new treatments methods and state of the art diagnosing tools, which in return requires high quality work force incorporated with sustainable economic background. On this note, the Ministry Of Health consistently strives to upgrade its services from the contemporary standards towards highly evolving landscape in medicine and surgery.
To achieve this, we realised that there should be adequate supply of trained human resource with the capacity and capability to meet the needs of the nation. Despite efforts taken to improve the quantity of medical doctors over the past years, the country is still facing shortage of doctors and specialists. It is worth mentioning here that, currently, we have an estimated *9000 specialists in the country, where *4754 specialists are in the MOH, and about 31% in the private sector.

As in the case throughout the world, our country’s need for more specialists is indeed a pressing one in view of many factors, amongst which is the everincreasing expectations of our Malaysians for higher quality health care. In addition, to cope with the rising demand for affordable, publicly-funded health care, the Malaysian Government has embarked on a programme to build more new hospitals and bring them closer to Malaysians, which is what many Malaysians have indicated that they want. In addition, a flourishing private sector is also building more hospitals to complement the efforts of the Government. Thus, the need for specialists seems to be insatiable.

Ladies and gentleman,

As we plan for the future needs of Medicine, the health care delivery system and its human resource requirements, education and training for doctors must be given due attention. The American baseball coach, Yogi Berra anticipated such change when he said “The Future is not what it used to be ! ”. The implication of course, we cannot provide future and newer services with current standards, skill sets and manpower strength.

In order to increase the number of specialists, the Government has agreed to increase the number of scholarships for the local Masters programme, from only 450 in 2007 to 1000 slots since the 2012/2013 session. Alternatively with such limited space provided by local universities, the Ministry is also encouraging our medical officers to pursue the specialist programme via various alternative pathways such as the Membership programmes. We are now in the process of enhancing the alternative pathway to make it more structured and more attractive, in order to produce more specialists to cater to the needs of the nation.

In addition, the subspecialty programme will also be enhanced. Young doctors graduating from local and overseas are also looking towards qualifying, not just as specialists in medicine, surgery etc., but also as subspecialists in specific fields. The Subspecialty Training Progamme, or the Fellowship Training Programme is a postgraduate training for “super specialisation” i.e. for specialists who already possess basic specialisation qualification. In 2001, this programme was formally coordinated and structured. Prior to that, it was managed individually. During the early restructuring, there were only 85 trainees in 26 programmes. Since then, the number of trainees had been increasing and by November 2014, there are 517 trainees in 109 programmes. Popular areas include Nephrology, Cardiology, Endocrinology and Urology. The duration of training is between 3 to 4 years and it can be done either locally or as a combination of local as well as overseas stints. As of January 2011, full Federal Government Scholarships have been offered to every candidates compared with the previous policy of giving them only to those pursuing attachment training overseas.

Ladies and gentleman,

The Ministry Of Health is fully aware of the nation’s needs related to health services and it is constantly looking forward to materialize each of its specific objectives. However, the acceleration of technology is increasing exponentially and there are many businesses out there to exploit it. For example, disruptive technology which is the term in practice now, are examples of groundbreaking concepts that are growing at an intense pace. Laparoscopic surgery was the 1st of such technologies. Currently, Robotic surgery is making waves with virtual reality and surgical simulation. In the past surgeons have to “cut and see”, presently it is “see and cut” and in the future it would be “combine see and minimally cut”. As much as it sounds very impressive, the Ministry of Health through its Health Technology Assessment Unit will evaluate these and other technologies wisely before jumping on each “new band wagon”.

It is expected that future surgical training will need didatic, hands on training and cross training, and, since robotic surgery will be in use commonly in use, the introduction to haptic technology may contribute to training the next generation of surgeons. This will bring tactile realism to medical education which will create engaging multisensory experience, which will help the surgeons to be more proficient as well as decrease medical errors and cost.

Ladies and gentleman,

The Ministry of Health with full cooperation from local universities namely Universiti Kebangsaan Malaysia, Universiti Malaya, Universiti Sains Malaysia and a few others are working hard to produce specialists not only in terms of quantity, but more importantly, a good quality specialist. Rising expectations from the patients and public should be the motivation for us to improve our services and performance.

In ensuring a better quality of health care to the patients, it is important to start inculcating the habit of striving for excellence in ourselves first. Soft skills are as important as technical skills if we are to provide the best for our patients. As stated by William A. Foste, “Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives.” As such I do hope as young doctors wanting to take up surgery as their calling, will need to inculcate and practice good communication skills not only to your patients but to their carers as well.

I hope all the participants will be able to gain an overview on the effort by Ministry of Health as well as other sectors in producing more specialists for our fellow Malaysians. It is a stepping stone for all of you and perhaps an eyeopener on what to do next to pursue your career in the surgical field, as well as other specialities. I would like to wish you all the best for your future plan and let us work together for a better health care service.

Sekian, Wabillahitaufiq Walhidiyah Wassalamualakikum Warahmatullahi Wabarakatuh

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