THE parallel pathway medical specialist programme has been in the news in recent weeks, growing from an urgent healthcare need into a racial debacle.

There is no dispute that there is an urgent need to solve the shortage of health specialists, especially cardiothoracic surgeons, in public hospitals.

But before a solution could be found, the matter has been hijacked by many parties who have turned the problem into one that touches on the sensitive issues of race, religion, and Bumiputera rights.

The Malaysian Insight revisits the issue in an explainer.

What is the parallel pathway programme?

Medical specialist training in Malaysia is largely provided by the public universities through clinical masters programmes and the Health Ministry via a parallel pathway.

The parallel pathway option offers on-the-job structured training for doctors who opt to sit for international examinations conducted by overseas institutions.

The programme allows Malaysian healthcare professionals to seek specialist training for selected postgraduate qualifications abroad to meet the local shortage of specialists.

What’s the problem?

The parallel pathway programme made headlines when the Malaysian Medical Council (MMC) refused to recognise the qualifications of cardiothoracic surgeons from the Royal College of Surgeons of Edinburgh (RCSEd)

As a result, Malaysian graduates – all practising doctors in public healthcare – sent by the government to study cardiothoracic surgery at the institution are not qualified to practise at home.

Four of the graduates are taking legal action against the MMC for its refusal to register them on the National Specialist Register.

The Malaysian Association for Thoracic and Cardiovascular Surgeons (MATCVS) said the MMC’s rejection of specialist registration applications has put patients at risk amid a severe heart surgeons’ shortage.

MATCVS said the Health Ministry launched the parallel pathway programme in 2016 in collaboration with the Academy of Medicine of Malaysia (AMM) and its international partner RCSEd. It said the programme was approved by the ministry, the AMM, and the National Heart Institute (IJN). 

MATCVS pointed out the RCSEd programme was fully recognised in Singapore, Hong Kong, and Brunei and accepted in the UK.

It said 33 surgeons have enrolled on the programme since 2016; 22 of them sponsored by the Health Ministry.

Legislative solution

It was reported in March that a shortage of cardiothoracic surgeons has left 1,500 heart and lung disease patients in government hospitals at risk.

The same month, Health Minister Dr Dzulkefly Ahmad told the Dewan Rakyat there were only 14 cardiothoracic surgeons working with the ministry.

To resolve the shortage the government would amend the Medical Act 1971 (Amendment 2012), he said.

Dzulkefly said the proposed amendments seek to address the gap between the parallel pathway programme and local master’s medicine programme.

He said the amendments would ensure that medical specialists who have completed training under the parallel pathway programme will be registered and recognised.

UiTM controversy

Prof Dr Raja Amin Raja Mokhtar, who is on the board of studies of the Universiti Teknologi Mara (UiTM)-IJN cardiothoracic surgery postgraduate programme, proposed that the university open its programme to non-Bumiputera to overcome the shortage of specialists.

He said such a move would be temporary pending the development of a similar programme in Universiti Malaya.

The Malaysian Medical Association (MMA) also urged UiTM to do the same.

UiTM, which has a Bumiputera-only admissions policy, is the only teaching hospital that offers cardiothoracic surgery specialisation in Malaysia.

But the recommendation was hotly debated on social media and quickly devolved into an issue of race and religion.

In response, Higher Education Minister Zambry Abdul Kadir denied there had been discussions to allow the admission of non-Bumiputera students into UiTM.

The UiTM students’ council and Malay rights advocates called for protests to protect the rights of Bumiputera students.

The student council launched a “wear black” campaign on May 16 in opposition to the idea.

Citing said Article 153 of the Federal Constitution, it said UiTM was incepted to give Malays, Orang Asli, and the natives of Sabah and Sarawak access to higher education.

Rights group Lawyers for Liberty said the Federal Constitution had been wrongly held up to defend the racial exclusivity of UiTM, calling the argument to bar non-Bumiputera students from UiTM a “false” on.

The student council later apologised for causing a “misunderstanding”.

Cabinet intervention

Recently, 11 cardiothoracic surgery trainees on the parallel pathway programme at the National Heart Institute and Universiti Malaya Medical Centre were told to finish their training at UiTM under a credit transfer programme for MMC recognition.

However, it was later reported that the plan had been put on hold because of UiTM’s Bumiputera-only admissions policy and a lack of funds.

The UiTM programme has only a provisional nod from the Malaysian Qualifications Agency and is yet to be recognised by the MMC. The first batch of trainees is expected to graduate in 2028.

Prime Minister Anwar Ibrahim said the cabinet will discuss the problems surrounding the parallel pathway programme on June 5.

Zambry said the proposed solution to the problem has been submitted to the Attorney-General’s Chambers for evaluation.

“The government is currently examining comprehensive solutions that also involve the law, such as a need for the Medical Act 1971 to be amended, in addition to matters related to the recognition of medical programmes,” he said.

He said the amendments to the Medical Act will be tabled in the June meeting of the Dewan Rakyat. – May 31, 2024.