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.