Letters
by Frustrated JPA scholar
I am a medical student sponsored by JPA to study in Ireland about to complete my studies. I write to you after reading your article on the rot of the Malaysian healthcare system. We JPA scholars here have been very frustrated with the JPA enforcing us to immediately return to the country upon graduation, barring us from continuing training as interns (equivalent of houseman) in the countries where we graduated from This would mean we cannot obtain the sufficient exposure that would make our training complete, and would off course, mean a waste of taxpayers money as there would have been no difference with studying locally.
JPA had announced recently that none of its medical scholars overseas will be allowed the opportunity to do further train overseas even at their own expanses, and are to return ASAP upon graduation. No scholar would be allowed to stay on regardless of the training posts they obtain upon graduation. To add to the spice of JPA’s foolishness, it seems that JPA gives priority to romantic relationships over the academic achievements of its scholars by giving exception to remain overseas to those who are married to a fellow JPA/MARA sponsored student who are still commencing studies in the foreign country concerned.
Till today, I have yet to comprehend the narrow minded policies set by the JPA. JPA seems to fail to understand that by allowing its scholars to stay on for postgraduate training, many will be offered positions in world-renowned healthcare institutions. The exposure and experience gained through these positions would be an invaluable asset to the country and the rakyat in the future. Unfortunately, JPA seems to be adamant in having fresh graduate doctors returning to receive Malaysian medical training, instead of allowing these fresh grads to further train themselves and one day return as first world specialists who will reform and infuse new uptodate skills in Malaysian Healthcare a few years down the road. Also of importance is the availability of funding to do research work in these foreign teaching hospitals, which is significantly lacking in Malaysia. Would it not make Malaysia proud if Malaysian Doctors were publishing their research work in heavy weight journals in the medical world. Upon return, these foreign trained doctors will then be able to start up a trend of research-based medicine, to the benefit of the ranking of Malaysian universities who lose out because of lack in research.
This immediate return policy has also stunted the motivation of many JPA scholars. Housemanship placements in Malaysia show disregard to academic achievements. It is random where one is sent to at best, and at its worst influenced by racism and cronism. This off course does not help in encouraging JPA scholars to strive to improve themselves. Knowing the fact that additional experience, eg opitional research and academic grades do not count later on, there are some who have lost motivation, and many who have been apprehensive in taking further steps to improve themselves due to the fear that the JPAs immediate return policy might put all their effort into waste by abruptly discontinuing their work.
Starting year 2008, there will be at least 2000 Malaysian fresh medical graduates from the various public and private universities sprouting throughout the country, not to forget graduates returning from Russia, Indonesia, India and Ukraine. This number is likely to rise over the coming years. Will MOH be able to cope with the demand for training posts? Will the ministry of health be able to provide enough housemenship positions, and if yes, will these posts provide high quality training, as the saying goes ‘too many cooks spoil the soup’? In the long term, will the ministry of health be able to provide enough specialist opportunities, considering its eagerness to do away with MRCP and only recognize the local masters program? My fear is that there will be a bottleneck down the pipeline, and many competent doctors will be failed by JPA and the ministry of health’s poor planning. Henceforth, to lessen the burden on the Malaysian Healthcare system, it would only be simple common sense to allow those graduating from foreign universities who are offered good opportunities to continue with their post graduate training overseas without having to return immediately, as it is the easiest way to gain access to train in these countries.
During one of the talks given by JPA officials who visited Ireland, a student raised a question on the rationale of JPAs ‘immediate return policies’. The officer in charge went in a rage and accused the people who wanted to stay as ‘just wanting to earn money’. I could not believe the narrow mindedness behind these words. For one, what is wrong with earning money? Also, many JPA scholars are top achievers, and view further career advancement as the driving force behind their intention to remain and continue training overseas. The plight of these JPA scholars has fallen on deaf ears of the JPA authorities. Many of JPA’s policy makers are not doctors themselves. How are they to understand the need of good training even at a post graduate level.
Finally, I would like to stress that all JPA scholars love their country, and would love to return to serve. However to my view, it would be better to return after adequate exposure to first world healthcare, as this would bring the most benefit to the rakyat. I am also fully aware that a contract is a contract, (despite the fact JPA changed the contract one-sidedly half way through our training from a penalty of RM160,000 to approximately a million ringgit) without prior warning), and if JPA remains adamant to prevent its scholars to further develop their skills overseas, the only thing we can do is to return as housemen. The authorities in JPA, however, should understand that to attract talent in the public service, the more effective methods would be by improving pay, ensuring fairness by meritocracy and adequate training opportunities,. By using brute force, many may return, but only with the intention of leaving as soon as the bond imposed is over.
#1 by iceman on Wednesday, 2 April 2008 - 9:39 pm
I find the original letter a little amusing. I dont think calling names and spilling out expletives will help in this matter, so I will attempt to counter the arguments as rationally as I can.
“This would mean we cannot obtain the sufficient exposure that would make our training complete”.
-> I’m sure as a worthy JPA scholar and also a med student, you do know that the disease spectrum in the western world and here in Malaysia is quite different. Going through your housemanship here will no doubt benefit you in the long term (since you so confidently said you love your country and will return to serve) because an early exposure to the diseases of the local society means you will be equipped to handle all of these when you specialize too.
-> Not to mention that there are local sensitivities and cultural aspects that a doctor needs to know while handling a patient. All these, will surely help you to grow as a better doctor.
Dont you agree?
“it seems that JPA gives priority to romantic relationships over the academic achievements of its scholars by giving exception to remain overseas to those who are married to a fellow JPA/MARA sponsored student who are still commencing studies in the foreign country concerned.”
-> This point I do agree with you to a certain extent. I think that policy is a little absurd and if everybody has to come back, then EVERYBODY has to come back.
“Till today, I have yet to comprehend the narrow minded policies set by the JPA. JPA seems to fail to understand that by allowing its scholars to stay on for postgraduate training, many will be offered positions in world-renowned healthcare institutions”
-> Well, it’s actually quite easy to comprehend, I’m surprised you do not know. In a nutshell, there are obviously a shortage of doctors (I’m sure you know that) in Malaysia and obviously the govt would prefer if you come back and serve the people here, and also to help ease the workload of your colleagues.
-> Also, you do know that to specialize, one need to work in the wards first and take a series of examinations which includes theory papers and oral/viva. And I dont see why that cant be done here? The first part will definitely be a theory paper, so I’m sure the medical bookstores here have the volumes for you to study, so that shouldnt be a problem. Besides, many doctors here take the local and foreign examinations. They do go over to take exams, to do their training, so you can too.
-> Oh, you mean those who do their postgraduate courses wont be offered a place in world renowned health care institution? That would simply be an insult to those who did their postgraduate courses here. Try reading a little on the achievements of local doctors.
“Also of importance is the availability of funding to do research work in these foreign teaching hospitals, which is significantly lacking in Malaysia.”
-> Agreed. Our research facilities or funding might not be the best around, but I’m sure you can help the Malaysian community while pursuing your academic interest. After all, isnt that what a doctor is suppose to do? To help the community and the Malaysian community needs doctors like you.
“Will MOH be able to cope with the demand for training posts? Will the ministry of health be able to provide enough housemenship positions, and if yes, will these posts provide high quality training, as the saying goes ‘too many cooks spoil the soup’? In the long term, will the ministry of health be able to provide enough specialist opportunities, considering its eagerness to do away with MRCP and only recognize the local masters program? My fear is that there will be a bottleneck down the pipeline, and many competent doctors will be failed by JPA and the ministry of health’s poor planning.”
-> I’m not sure what are you getting here. Not enough training posts? The latest statistics shows that the doctor-patient ratio in Malaysia is 1: 1500. With the emergence of more hospitals, like the Putrajaya one, the Sultanah Bahiyah Hospital in Alor Setar (which has a pretty good concept like a open garden), I doubt there will be lack of training posts. If you think the Peninsular dont offer you good exposure, try the West Malaysia instead. There are always a shortage of doctors there, especially in the rural areas. Of course, I’m not talking about specializing, I’m talking about what you need to do as a fresh graduate; a houseman, that’s where all doctors start. The 2 years you spend as a houseman will probably determine what kind of doctor you are, so I believe that crucial to your education as doctor.
“Henceforth, to lessen the burden on the Malaysian Healthcare system, it would only be simple common sense to allow those graduating from foreign universities who are offered good opportunities to continue with their post graduate training overseas without having to return immediately, as it is the easiest way to gain access to train in these countries.”
-> Let’s not kid ourselves. We all know the working conditions, the workload, and the pay doctors get as govt servants arent very motivating. Not many will return, and that’s a fact. But I agree that changes need to be made so that doctors will want to return and stay.
“Finally, I would like to stress that all JPA scholars love their country, and would love to return to serve. However to my view, it would be better to return after adequate exposure to first world healthcare, as this would bring the most benefit to the rakyat. I am also fully aware that a contract is a contract, (despite the fact JPA changed the contract one-sidedly half way through our training from a penalty of RM160,000 to approximately a million ringgit) without prior warning), and if JPA remains adamant to prevent its scholars to further develop their skills overseas, the only thing we can do is to return as housemen”
-> If you really love your country, then you should know the situation of the healthcare system here and the need of housemen, so if doctors-to-be like you do not help the country, who will?
->Yes, a contract is a contract. Even if you are not a JPA scholar, the govt stipulate that ANY medical graduate from ANY college around the world needs to come back and serve the govt for 2+3 years now. So, I’m sure you know that when you want to become a doctor in Malaysia, and perhaps you should learn to honor the contract.
Nobody is saying you shouldnt pursue a postgraduate course overseas, but much of doctors like you are needed by the Rakyat, and that is what a good doctor will attend to.
Regards,
Houseman in Malaysia.
#2 by riha on Monday, 7 April 2008 - 7:26 am
hiya..there are only very few non malays who are on jpa scholarship to read medicine overseas.What about those MARA scholars who dont have a bond attached in the first place?Whose money are they using up?Why isn’t anyone making noise about that?
#3 by lakilompat on Monday, 21 April 2008 - 3:54 pm
Non malay rely on what?
#4 by skynet on Tuesday, 22 April 2008 - 6:50 am
After reading the posts, I have came to my own conclusion.
I must admit, a doctor does get a lot more exposure working in M’sia. Hands-on skills, spectrum of diseases..I could have a list of things that oversease can’t provide. I have to admit again, another reason to work in overseas is the money. After all, we are only humans, we doesn’t lean over to the side who pays more? I’m not trying to provoke any anger but I’m telling the truth, you can’t deny this. Any M’sia graduates who are given a chance to work overseas, I’m not no one would decline it.
Chasing freshly graduated medical JPAs to go home isn’t a wise move. Personally, I think they should be allowed to stay overseas as long as they are taken into overseas training programme, and make them go back M’sia when they are finished as a consultant,
It is true that the spectrum of diseases is not the same in overseas and in M’sia. But every doctor who return to M’sia will have a transition period to adapt themselves, given a 6 months period I’m sure they can refresh their medical knowledge to adapt the local settings. One of the things that a M’sia graduate is not trained in is communication skills. Althought it’s not a big problem in M’sia as M’sia doctors are alway the ‘boss’ to their patient, I think as a doctor we are not just treating the disease. We are treating the disease, the patient and their family. The way overseas doctors communicate with patient is very different, and I think it’s better than local graduates. Do we not want these overseas graduates to take these skills back home?
Doctors to patients ratio of 1:1500, building more hospitals…what good is it to build plenty of hospitals when there are not enough specialists to train?? I don’t think having all JPAs back to fill these newly opened hospitals, with no proper/incompetently trained specialists is going to help the country. The reason I’m saying incompetently trained specialists is because of the government’s policy. Per-U/college graduates who did badly, some even failed their exams are taken in to ’special’ programmes, such as SLAB (or something like that), and they have all the good training and privilages to become a medical consultant in the shortest and fastest way. These people are then placed in hospitals to train fresh houseman. Think yourself, if you parents are admitted to hospital, do you want these guys to treat them? Honestly, I DON’T.
Chasing fresh HO to go back is not a wise move. Instead I think they should be allowed to stay as long as they are taken into overseas training programme. JPAs can call these guys back when they have finished as a specialists/consultant, by that time they will have the skills and technology to bring home for the benefit of M’sia. I’m not JPA scholars but I just want to give my opinion. I have been overseas for 4 years and I have seen many long graduated JPA/MARA or other scholars working here, they are married and have children. Why does the government not forcing them back since they have been outside for SO long. What’s that about?? If the government wants to call back scholars, these guys should be called back first.
One more point. All medical graduates from overseas have to serve government for a fixed period of time on returning. Why? If I were to return, I will want to work with government first to adapt myself. But I just don’t like the idea of forcing returnees to work for government when we graduated without spending government’s money.
I’m just sounding my opinion, there is no right or wrong with my arguments. They are purely my thoughts. I love Malaysia, but with the current government’s policies, there is no good for me to come back. I’m sorry.
#5 by eternal1098 on Monday, 28 April 2008 - 7:08 am
I am a medical student studying in the UK, under private (i.e. parents) sponsorship.
lets start by saying my parents are not rich, indeed my dad had to come out of retirement to support me. I got straight A’s in college, and am in the top 10% of my medical batch at uni here.
Despite that, I didn’t apply for a scholarship as my parents believed it should go to those who really need it (i.e. those who can’t afford at all). Also, my family fell in the bracket of not being quite poor enough for me and my brother to receive scholarships, nor quite rich enough to have contacts. i should say i’m not a malay (if thats relevant at all, and it SHOULD NOT be)
You can imagine the contrast over here, as many malaysian scholarship students in my course come from richer families then i do. One has a ferrari at home, another goes on holiday about 4-5 times a year. One JPA student here has a dad whos a doctor, and a mom who’s a dentist. Both my parents never got the chance to attend uni, but worked hard and saved up their whole lives for my education.
While I admit some students here are genuinely poor and deserve the need for a scholarship, there are MANY whom you would think can survive without it as their parents can certainly afford to pay for them. ’scholarship’ money thus goes to other expenses such as the newest PS sets, flatscreen tvs, regular weekend trips to London etc. While this may sound stereotypical or something I would say out of spite, it is the truth.
I have to take weekend jobs just to cover my rent. But i’m happy anyway, as i RECOGNIZE the opportunities i’ve got studying here in england.
This is what makes me angry. My brother also trained in medicine here, also privately sponsored. He was asked repeatedly to return to the country to serve, as a surgeon. I too have been told I should go back. The government constantly laments that we are unpatriotic or traitors?
This makes me sad. If you want people to serve the country, then please give scholarships to those who deserve it. It is frustrating seeing money (our parents taxes) been thrown around to richer kids who do not deserve it. It is just insulting, and a slap to our faces. There is a whole generation of privately funded but equally talented/ intelligent young professionals studying overseas who are not wanting to go back, as the government has snubbed us, or refused us scholarships, and instead give money (our parents taxes) to those who do not deserve it .
Is the country facing a ‘brain drain’? If so, ask yourselves why
What makes me even sadder is tht JPA students do not want to go home to serve. I did my electives in Malaysia, and it made me realise that training in UK is nowhere near enough to be competent to practice in Malaysia. The diseases are different.The patients are different. And the system is different. A fully trained ‘consultant’ in the UK will still be lost in a key Malaysian hospital.
To Frustrated JPA Scholar, just think about what you’ve said. People have paid for you to study abroad, and you do not want to go home.
I do want to go home. And the reason is simple. Its because my parents are at home. So are all my elderly relatives. These people are people we know, and they need good doctors.
#6 by Forequality on Monday, 28 April 2008 - 12:06 pm
Your contract is for undergraduate studies. Complete it and come back to work or pay the RM160,000.
Do not complain about the penalty clause of RM160,000. That was a mistake of the government from 1970s. They did not revise it proportionately to the increase of fees. The clause is a “joke” it should be based on actual sum spent on you but it is not. The reason it is so is because the scholarships are reserved for children of people at “high places” (who can and will pay the penalty and not serve the govt), with a few given to the “lucky ones” like you. You are lucky enough to get a scholarship.
Do not complain anymore!!! For you information do you how many rural poor Malay children were sent overseas on 50% scholarship and 50% loan for courses that leave the unemployed with a loan to pay when they come back.
#7 by Ah Huat on Wednesday, 30 April 2008 - 6:40 am
Although I symphatise with JPA medic scholars who wish to undertake their housemanship overseas for the sake of experience and gaining the necessary skills, I am nonetheless relieved to find out that JPA is now putting in tougher measures to ensure that scholars return to Malaysia and fulfill their obligation to serve the nation.
According to the Star article recently, there are 63 medical students who did not return last year. Each students are funded up to £1.1m each to complete their course. Thats £63m of tax payers money being wasted on ungrateful students in UK alone. This is simply unacceptable!
By all means, let us encourage our bright and young minds absorb as much knowledge, experience and skills as they could, but the government should also be vigilant in ensuring public money is well spent.
As for “Frusted JPA Scholars”, I am afraid his plight is littered with the signs of someone who has lost the spirit of altruism that may be embodied by the scholarship he was given. In his own words, “many will be offered positions in world-renowned healthcare institutions” and “For one, what is wrong with earning money?”. As a taxpayer, I feel I have a right to remind him/her that a JPA scholarship is a privilege, not an entitlement. So whilst although the new JPA ruling seems harsh and knee-jerk (due to poor foresight and planning…but thats JPA for you), I would advise “Frusted JPA Scholars” to put things into wider context and consider the moral and contractual duty he/she has with the government and rakyat. Go back and serve the nation!!
#8 by no-nonsense Malaysian on Monday, 16 June 2008 - 9:00 pm
I see there’s no need for jpa medical students to obtain experience or skills from overseas country since that same experience and skills can be obtained in Malaysia. What that scholar is doing is simply despicable.
#9 by no-nonsense Malaysian on Monday, 16 June 2008 - 9:12 pm
his duty is to serve the Malaysian people but he just wants to earn his paycheck in British pounds and migrate there. What is he trying to prove? Because of irresponsible scholars like him, the gorvernment refuses to send deserving students to established medical universities in U.K. What the government should do to scholars like him is to sue this fella amounting to what the expenses the gov’t has paid for him. How I wish the gov’t found out about your attitude and send you to Indonesia instead!
#10 by brave_in_front_of_truth on Wednesday, 4 February 2009 - 1:37 pm
Speaking of unfair…what is unfair?for the frustrated JPA scholars..
your reaons or rather excuse from the letter seem so reasonable,so beautifully written.First of all,you should be content that you got the scholarship,as many and i mean it,many who have same qualification with you,maybe better qualification than you actually don’t stand a chance securing the scholarship.we knew that it is by \luck\ for being selected to be the scholar.
what is justice mean to you?when you see you have the same qualification with other scholars but cant secure the scholarship?when you see that other people who are 10*times or maybe 100* richer than you actually get the scholarship?just because his/her parents are the so-called \influential people\like the \dato\,or the very renowned professional?i tell you this,this is unfair.
yes,I did apply for the scholarship a few years backand went through the interview.And I turn out failed to secure the scholarship.Thats alright i assure myself,and console myself that its still fair in the end as the scholars need to came back and served the country for years,it is ok as the scholars need to pay back the money.I try so hard to assure myself until today,though it passed a few years back.You never know the grief of the \unlucky\ one like me and some of my friends who then continue our study in STPM.You certainly don’t know the disappointment of our beloved parents.Mum and dad,I know you are dissatisfied,I know you are still hurt.Yes,I understand all this. And the \lucky\ one,don’t know how to appreciate it.Sending you all to oversea is NOT the people or the nation obligation,you should knew it.What a shame!yet,we heard complaints all over from the scholars how the money is not enough for them,how they are bonded,how they cant come back during festival…how this and that.enough…enough…
Its more unreasonable when I knew that many scholars actually indeed wanted to \escape\ from the repayment!really!i ask myself why?is it what education taught us?
my parents are working hard just to pay us to enter local university.yes,you see it correctly,its local university.and what the JPA scholars say is totally not making any sense to me..
we will be brave in front of truth.we will learn to appreciate what life give us when we were treated unfairly.
eternal1098:i totally agree with yoo!two thumbs up!