Sub-standard doctors

NST: Doctors incapable of diagnosing disease? Shocking as it may seem, some doctors who handle patients have no clinical skills. Bluntly put, the patient is something of a guinea pig in their hands.
These doctors may have sufficient theoretical knowledge, but they lack practical experience.
Another shocker: Some of these doctors are products of medical colleges operating out of shoplots, with no proper facilities such as laboratories and insufficient lecturers.
The main problem is the mushrooming of private medical colleges. Of the 17 medical colleges in the country, only eight are public medical universities.
There are simply not enough places at designated government hospitals for medical students to undergo practical training. The problem is expected to worsen as more colleges are approved by the Ministry of Higher Education.

Director-general of Health Datuk Dr Ismail Merican acknowledged that government hospitals were unable to accommodate the increasing number of students needing clinical training.
"There are simply too many of them," he said. "Whom do we blame when we get doctors who do not have the necessary clinical skills?"
Expressing concern, Dr Ismail said he had come across doctors in hospitals who did not have clinical skills such as patient care, familiarity with the signs and symptoms of diseases, diagnosing illnesses, and doctor-patient communication.
"Theory is okay, but what about clinical skills? We have the same problem with allied healthcare staff such as pharmacists, radiologists and nurses," he told the New Straits Times.
Students are required to start their clinical skills training from day one, but this does not always happen due to the shortage of places.
"Although we need lots of doctors and allied healthcare staff, we need them to be of quality," Dr Ismail said, adding that he was also aware of private medical colleges not having enough lecturers.
"My advice is, consult the Health Ministry before setting up medical colleges. This is because invariably they would want to use the ministry’s hospitals. When we say there are no more places, they get upset."
He said to meet the pressure for places, the ministry had opened up some of its district hospitals to medical students.

University Malaya Medical Centre director Prof Datuk Dr Mohd Amin Jalaludin said the programmes run by private medical colleges had to be closely monitored so that standards defined by the National Accreditation Board were met.
"If the standards are not met, we will not have quality doctors. We want safe and quality doctors for Malaysians," he said, adding Universiti Malaya set high standards and offered excellent infrastructure, curriculum, teaching staff and facilities.
While more medical colleges would grant Malaysians better opportunities to pursue medicine locally and reduce cash flow out of the country, Dr Mohd Amin said, it should not mean "mass production and compromising on standards and quality".
He feels having more medical colleges would only dilute the academic staff. He said he was aware of private medical colleges employing expatriates to teach, with some having difficulty getting lecturers for certain programmes.

UKM vice-chancellor Professor Datuk Dr Mohd Salleh Mohd Yassin agreed that there were not enough teaching hospitals in the country. He said some colleges might not be able to cope with the high turnover of lecturers.
Saying those wanting to start medical colleges had to be responsible, he added: "There is no shortcut. I have been in the medical faculty for 22 years and I know the biggest problem is getting the proper teacher-student ratio. Can private schools afford this requirement? Do they have the required infrastructure?"
Dr Mohd Salleh called for the consolidation of medical colleges.

Medical lecturer Dr Kuljit Singh said: "Private medical colleges should not be built just because of demand or because the business is lucrative."
Saying it was difficult to get experienced teaching staff, he added: "The majority of doctors in government hospitals are juniors and lack teaching experience. We seriously lack a good teaching force and thus end up getting foreign lecturers."
Dr Kuljit said private hospitals should allow medical students to do clinical training at their centres as part of their social responsibility.