I would like to respond to the letter HUKM Cardio Unit's disheartening move.

Hospital Universiti Kebangsaan Malaysia has good surgical, neurological, neurosurgical, obstetrics and gynecological servcies and so on. Let us not forget that.

Let me remind all that all of us working in a medical faculty are making a big sacrifice. We do not get paid for rendering clinical service whilst Health Ministry doctors get paid an - albeit a nominal - honorarium annually for teaching duties.

In Hong Kong and Singapore, lecturers are paid separately by their health ministries for performing clinical duties. This is on top of their basic salaries (including clinical allowances) as a lecturer. Indeed, external examiners have often remarked how 'unfair' it is to be a lecturer at a Malaysian medical faculty.

The message is that medical lecturers elsewhere are always paid higher than their counterparts in the health ministry who opt not to teach at all.

The bottom line is that (good) people still leave the teaching universities because of the poor remuneration when compared to the private sector or other teaching institutions. How can we 'replace' the cardiologists if the bottom line remains the bottom line?

Credit must be given to HUKM's director and the dean of UKM's Medical Faculty for trying very hard to get replacement cardiologists and cardiothoracic surgeons for HUKM's Cardio Unit. All of them demand at least a professor's pay despite not meeting the criteria. See what the bottom line is?

I think the problem at HUKM's cardiology clinic is real and, of course, must be addressed and resolved immediately. But, hopefully, it is also sending a message to the government about the 'bottom line'.