Parallel pathway: Amend Medical Act or change framework?

Lawyer New Sin Yew has backed the idea of amending the Medical Act 1971 to solve the current impasse over the parallel pathway programme for cardiothoracic surgeons.

The programme began to attract a lot of attention, especially after UiTM was urged to temporarily allow the admission of non-bumiputera medical students to continue their studies up to specialist level in the field of cardiothoracic surgery.

This came after the Malaysian Medical Council (MMC) rejected the application of four cardiothoracic surgeons to be listed in the National Specialist Register.

This was because the council did not recognise the Fellowship of Royal College of Surgeons of Edinburgh in Cardiothoracic Surgery (FRCS Ed) qualification the graduate students had obtained.

In April, Health Minister Dzulkefly Ahmad said the Medical Act 1971 (Act 50) will be amended so that all trainees, especially those with the FRCS Ed qualification, can be registered and recognised.

New agreed, saying in “The Great Parallel Pathway Debate” event yesterday that there is a clear need to amend the act so that these trainees can be recognised, and further address the problem of a lack of specialists in Malaysia.

He cited the ratio of four experts per 10,000 population in Malaysia, which is much lower than the average ratio by the Organisation for Economic Co-operation Development (OECD), which is 14.2 experts per 10,000 population.

“The government is trying to fill this gap through the parallel pathway programme, and it will only be successful if entry barriers are addressed and bureaucracy can be minimised.

“It doesn’t make sense when an expert has to refer to two bodies to be recognised and it’s irrational when the Health Ministry recognises it but the MMC doesn’t,” he said.

READ MORE: KINIGUIDE | Parallel pathway - what is it and why is it an issue?

New pointed out that the health minister has the power to issue directives and that the minister appointed 15 MMC members while health director-general Dr Muhammad Radzi Abu Hassan is the council’s president.

Health Ministry has power over MMC

New brought up Section 8 of Act 50 stating that the minister has the authority to issue instructions that are in line with the Act and the MMC must recognise the instructions.

“The Health Ministry can use its power over MMC if it wants to. These two bodies must be parallel,” he said.

He likens this dilemma to a storyline in the Netflix series “Three Body Problem”, where a simulation game in which a planet has two suns and is struck by disaster because it is caught in the gravitational pull of both.

“The inhabitants of the planet are suffering. I’ll let you guess what the two suns are in this case.

“MMC has stated its position that it does not recognise the parallel pathway for cardiothoracic surgery (PPP-CT), so the solution is for the Health Ministry to intervene and recognise it through the law,” he said.

“PPP-CT is invalid only because the MMC does not recognise it. The Malaysian Qualifications Agency (MQA) and all other relevant legislation do not at all restrict the MMC’s authority to recognise PPP-CT under Section 14B of the Medical Act,” New added.

At present, he said, the only way to be registered as a specialist is to follow specialist training at an institution recognised by the MMC.

“The problem is that the government recognises these royal colleges in the UK and considers its graduates to be able to serve in Malaysia but MMC has not done so.

“What the government is doing is abolishing the discretionary element of the MMC (through law) in recognising colleges and training in the parallel pathway programme,” he said.

Easier to change programme framework

However, Galen Centre for Health and Social Policy chief executive Azrul Mohd Khalib said Act 50 does not need to be amended to solve the problem.

“This is a simple and clear issue. It does not require amendments to existing laws.

“This is an issue of compliance with the requirements of Malaysian higher education contained in the law, particularly the MQA Act 2007 and Act 50,” he said.

Describing the parallel pathway as an education issue, Azrul said instead of amending the law, it is easier to change the programme framework to comply with higher education legislation.

He said MMC was only carrying out its responsibilities and making decisions in line with Act 50 and the MQA Act 2007.

“The National Register of Experts exists to guarantee the standards and quality of all experts in this country. The standards must be the same for all areas of expertise, based on the specifications of their expertise and in line with the regulations.

“Should the parallel pathway programme be exempted from MQA standards because it is run by overseas institutions? How can the amendment of Act 50 deal with this situation?” he questioned.

He further said that the programme - which is not registered as a higher education provider and is through an MOU with an international college - is not the same as local postgraduate programmes run by trained lecturers and recognised universities, and administered under several acts.

“I don’t think the move to amend Act 50 is a mistake, I just feel it is unnecessary. The existing law is sufficient for our needs,” he added.

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