With regards to the Crimea State Medical University affair, the Malaysian Medical Council is, in my opinion, unfortunately merely an arm of the civil service and a part-time mouthpiece of the government though it has so-called 'nominated' and 'elected' representatives will always claim to act in autonomous way.

For example, the president of the MMC, via conditions stipulated under the Medical Act, has always been the director-general of health - a powerful civil servant, but who, of course, is at the beck and call of the health minister. What better way can there of controlling the pack?

Nominated members on the MMC are from institutions of higher learning and, in essence, can be, just instruments of the universities (and, by virtue of various other clever cabinet-legitimised acts, the government of the day).

Elected MMC representatives may be diligent individuals with high integrity but they can easily be outnumbered in the democratic process by the sheer number of pro-health minister supporters on the council. With their numerous conflicts of interest, most MMC members just cannot be autonomous and act appropriately at the same time.

In reading, for example, the Private Healthcare and Services Act of 1998, one can easily conclude where the power lies. It is with the minister of health and, sadly, the enactment of this act was a pure reflection of abuse of power to ensure Parliament endorsed the power the minister had over the medical profession in the private sector.

By nature of these facts, it would not be difficult to understand how the MMC can be and will be an instrument of the government of the day, in this case, the perpetually ruling and corrupt Barisan Nasional.

Unless the public knows about this and unless the profession can rise up in arms, the situation will remain with its status quo or continue deteriorating further .

Whilst some suddenly pat the MMC on the back after years of well-known complacency, my two questions about the Crimea State Medical University de-recognition debacle are:

1. What is the number and ethnic composition of Malaysian students currently studying there now and in the past?

2. Is the decision to remove recognition politically motivated or has the MMC finally shed its milk teeth and learning to bite effectively?

I agree with Dr K Inbasegaran that it is timely for all candidates presenting for full medical registration to pass or be exempted (though not cursorily) from a common standardised autonomously regulated and administered professional examination.

It would be then be interesting to see whether CSMU graduate can pass this exam. If they do, then there must have been something dubious about the MMC's decision.

Fellow Malaysian doctors, let us unite and restore the dignity and autonomy of our profession and hope that the amended Medical Act will address this issue.