eternal1098:i totally agree with yoo!two thumbs up!

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!!

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.

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.

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.

“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.

However, in this case, I believe the argument that Malaysians are ‘not getting our money’s worth’ from these scholars is absolutely ludicrous. If these so called ‘defenders of taxpayers’ money’ really want to make a difference, their energy would be most useful chasing those indulging in corruption of up to billions of Ringgit, and not innocent medical students who actually are presenting sound arguments for their extended stay.

During my housemanship, I have to undergone my hard time too as my worst time was needed to work for continuous 48 hours without sleep and on top of that have to remember all the 40 patients history, presentation, provisional diagnosis, lab investigation as the next plan for each patient. You need to present to the specialist all the above information 5 times a day WITHOUT looking into the files. Which patient discharge today, which one is new patient? Sounds impossible but it can be done.

“When we do electives in Malaysia we are shocked by how Malaysian doctors write diagnosis, without full information of stages, classification and complication. It’s like you need to search through the whole thick case report and while trying , to read the illegitimate handwriting, work out painfully what is exactly wrong with the patient.” – I agreed with you, but take into consideration that you are looking a note that is from a working doctor, he is not suppose to write every patient case like ‘text book’ format and you student just read and learn. It like what I mentioned to you the approach, if you know what you want, you extract the important information from the 2 inches thick note, NOT to read and copy everything from it, otherwise you have endless job to do.

Doctor try to discharge patient before weekend. I guess the situation is same as Malaysia as well. The reason behind is the hospital need more beds to accomodate weekend patient. Beside working as medical student, have you ever considered the work and stress of the staff nurse and others like doing all the dirty work (changing diaper, washing dirty patient & facing with difficult patient etc).

Russian doctor earning less than bus driver? Compare to my time, my oncall earning only earn RM25/call (till 2004 I suppose)- it was even lesser than those who working in McDonald and labour. I did’t even mentioned it to anyone (since you brought it up). My worst time was 14 calls in a month and only earn RM350 extra in a month. Houseman now is earning RM150/call. You can’t compare it with other profession. You are not going to work in Russia later.

Put away all your unsatisfaction and frustration. Concentrate of what you suppose to learn now. What I advise you further is the 2 year housemanship is utmost important to all the houseman. This are the time that your future characteristic as doctor are formed. If you ‘curi ayam’ and lazy in the training. You might able to pass the posting, but later when you go to the rural area or working alone later, if you know nothing or a little thing only, the loser still the patient. So be prepare to undergo the hell like training and ‘torture’ by the system. If you can sail through it, you’ll be very much satisfy later.

I don’t care where are you coming from (UKM, UM or from well known uni), but if your attitude is wrong, then sorry to say that, I’m worry for the patient treat by you. Better go sell drug.

Lastly, you earn the respect from the people for what you did. I really wish you can prove that I’m wrong and I’m looking toward it. I can see that people always complained about Malaysia Health System. But can you find any place in the world that you only pay RM1 for the emergency doctor treatment (including CT scan, CXR and treatment), outpatient clinic and others. Malaysia situation now is 30% total doctors in Malaysia are working in government and they’re seeing 70% total patient in malaysia.

Do you know that some rich people use to come to government hospital paying RM5 and leave with expensive medicine costing >RM1000 even they are afford to pay it. Why some terminal / bad prognosis patient always ended up in government hospital after their money has been ‘squeezed’ totally by the private hospital? Do you still think government hospital is bad, I don’t think so. Why nobody see this??????

There are positive and negative aspect of each health system in view of different country politic influence and situation. So we shouldn’t apply other country health system to a country. Russia don’t have majority of Malay, Chinese and Indian people and Malaysia don’t have a lot of Russian people.

Wish you all the best.

i meant RCSI graduates have been subjected to……….

If you’re so smart, did you do your electives back in Malaysia? Have you seen how the doctors back here are more competent? Did you realise how they’re more of an all rounder rather than the slacking doctors in Ireland? I am not saying bad things about the Irish health care system but though we have horrible working hours here and a pay that doesn’t seem fair, our own health care system here is good!

Then again, maybe you think that you’re just too good for this country.

Let me ask you one thing, are you being a doctor because you want to help people? or you’re just doing it because of the money? most of the people I know who stayed back to work there do it for the money, as we know interns could have a pay up to 9000 euros if they work hard enough. Don’t give us the lie about working there for experience. We all know that working in Malaysia gives a whole lot more of exposure.

I wonder why JPA is giving scholars to such brats.

Correction : I’m not calling all scholars brats. Just to a few. I do know the last sentence is a judgmental sweeping statement, but I also know, many would agree with me on the statement.

Most Malaysians would like to see him and the rest of the JPA scholars back to Malaysia, and I have a feeling that most JPA scholars would want to come back. How do I know? Because I’m one of these JPA scholars and I sincerely want to come back.

I agree with most responders that the JPA scholarship scheme is viewed as a waste of money. But what I don’t agree is sponsoring this writer a waste of money. S/he has at least raised a lot of problems that we need to address, and this awareness stems from the exposure we gain overseas.

Malaysian health & education systems are not heading the right direction. Our universities continue to slide down the world ranking, and our people is viewed as less than competitive in the global market. We are short of doctors at home, yet we don’t train those who did well at school & wanted to do medicine, and we certainly don’t treat our doctors well enough to keep them in the public system. Many simply wish to complete their compulsory terms and leave the system. Those who are compassionate enough to serve the Rakyat only later regret they are being left out in the ever Money oriented society.

Instead of attacking the writer personally and using derogatory description, let us ask a few questions:

1. don’t we all want the government to provide a free and fair education system? Instead of sending a few hundreds of scholars (mainly Malays) overseas doing bachelor degrees, JPA should channel the fund to local universities and hospitals, and improve the standards locally. I could not imagine JPA spending millions of ringgits on scholars including myself, only to see our valuable money goes to foreign economy, universities & hospitals. This money is better spend on improving our hospitals and providing more local scholarships, medical training positions & research funding. Speaking of scholarships, these should be awarded based on citizenship and meritocracy. A racially bias scheme would only undermine our unity and fuel resentment, and I call for more transparency in their selection.

2. don’t we all want a health system which has adequate funding & equipment, so that we can truly raise the Rakyat’s health standard? How can we expect these scholars to serve the Rakyat when our health system doesn’t have the financial capacity to provide for the Rakyat? Worse still, they come back as housemen and not fully trained doctors/specialists. Moreover, western trained doctors have acquired the knowledge, skills & experience from developed countries, and these assets are completely wasted if there is no opportunity for them to share & practise on their newly acquired knowledge, and that local doctors reject/belittle their views and continue with current standards of care. Malaysia is NOT a poor country. We have great human & natural resources and we have a proud multicultural history. The fact that our health & education systems are so depressing is because our government places little emphasis on these fundamentals of society. We see multi-billion dollar megaprojects failed and rampant corruptions that sap the tax-payers money. Effort should be made in stopping this blatant waste of money and more effort should be made to improve our health system and to encourage the JPA scholars to return home. Don’t let the government brain-wash you to believe the country can’t afford a first class healthcare system for the Rakyat.

3. don’t we want our local doctors to be better looked after, so the best local doctors remain in public system to serve the Rakyat and teach the medical students? Many JPA scholars are relunctant to return home to serve because of the many sad stories they hear from those who returned and those working in the public system. No one with some intelligence would want to return to a place which they will one day rot & live in despair. This is not being selfish or unpatriotic, this is simply being prudent. Many local doctors are eager to leave the system, and so it comes as no surprise why JPA scholars & western trained doctors are so relunctant to return to a system which even the locals are abandoning. And this is the root of why we are short of doctors – not because the few hundred JPA scholars not returning home, it is because the healthcare system is in such bad shape that doctors are leaving. We should call on the government to improve both our education & health systems, improve the doctors’ wages & working conditions, and clamp down on corrupted officials.

JPA scholars in general are not ungrateful Malaysians, and I myself don’t intend to use taxpayers’ money for my private indulgence. My dream is still to return to my country which I can truly contribute my part in improving the healthcare system, and not being exploited as cheap labourer. Forcing JPA scholars to payback lumpsum would only make matter worse. What JPA scholars, like the writer, want to see is light down the tunnel when they return home one day. No amount of coercion and criticism is going to make these JPA scholars return unless we truly address those issues of grave concern. I am confident JPA scholars will return in droves if conditions in Malaysian healthcare system in particular, and Malaysian politics in general, improve for the better. Forcing JPA scholars home would NOT improve our healthcare system because the main problem is our government’s lack of interest in our healthcare system. On the surface, it may appear they have breeched their contracts and are an ungrateful bunch, but their action serves a clear message that drastic changes are needed to improve our healthcare systems. I hope the recent election results send a clear signal to the BN-led government to clean up its act, or we’ll see a new government in 5 years time, which I hope will be more successful in moving the country forward, and in doing so, attract the JPA scholars including myself to proudly return home.

I am very well aware that I am currently engaging in a debate with a potential superior who will most likely try to demoralise practically every Russian graduate without at first giving us a chance to prove ourselves.

I admit, I have zero experience in terms of treating a patient, I admit as well that I have never been to a “Malaysian Cardiology Conference (or others) and listen to the country best brain of how they criticising the lastest research together with their experience”.

But I guess you have to admit as well, that you have not been first hand in Russian hospitals to see how Russian doctors work in a different setting from Malaysia. When we do electives in Malaysia we are shocked by how Malaysian doctors write diagnosis, without full information of stages, classification and complication. It’s like you need to search through the whole thick case report and while trying , to read the illegitimate handwriting, work out painfully what is exactly wrong with the patient. Not to mention how doctors try their best to discharge all patients especially when weekend is approaching. And the patient education. Patients in Malaysia mostly do not know what medication they are taking. it would be either the “blue tablet” the “yellow tablet” or the “small white tablets”. Ask any babushka (ah mas) in Russia, they will tell you the names of the medication straight on your face, and don’t be surprised if they managed to tell you as well what the medications are meant for. And oh the compassion for patients, doctors in Russia actually LISTEN to patients. Have I mentioned that doctors in russia earn less than a bus conductor and a bus driver? Their passion for medicine and heart warming doctor-patient interaction is truly an eye opener.

Having said that, I don’t think that all doctors in Malaysia are interested in discharging patients only. There are quite many who win me over with their dedication and professionalism. Because unlike you sir, i don’t judge the whole basket of apples rotten when only a few of them is bad.

And for your information boss, my friends and I when copying lectures, we do use abbreviations like CXR, AXR, Rx, Ix. Please do not assume that you know us when you don’t know us at all.

So boss, we lack in the skill in approaching patients? Thank you for telling me that, I will convey your message to my fellow friends and we will try our best to improve on that.

As for you sir. I just hope, that you can be more open and stop thinking that Malaysia is all that good and Russia is lousy and beyond rescue. Everything and every one has their good and bad points. We the Russian medical students are really sick of how you doctors look down on us without giving us a chance to prove ourselves.

As for “expecting to change the recent health system”, how dare I dream to change our health system when I see that it’s so hard even to change your mindset on ALL RUSSIAN GRADUATES.

For your information, we are human beings with feelings too. We want to be a doctor as much as the local students and we work hard to achieve our aim too.

We will prove you wrong. I will prove you wrong.

Thanks anyway boss. You gave me more motivation to be a better doctor, and a better human.

You haven just ‘seen’ the condition of both countries. In fact your are not part of the either health systems yet. Everybody can give commend of what they think but when you are really practise as a doctor and bearing the responsibility as health personal, you perception will change.

I believe sending student to overseas is not a waste BUT I do believe that sending a student overseas that who is not coming back or if coming back only complete the compulsary service and leave to the private later is a ‘waste’ to the tax player money. How many of the JPA scholarship oversea students manage to complete the 10 years bond service with the government? I afraid I don’t have any in my mind at the moment.

Pls come back to work in Malaysia and give commend later. Are you planning to stay to complete 10 years bond? I afraid later the excuses are bad health system, how come other lazy one get promoted and I don’t, I have been placed to the place that I don’t want, a lot of on call, low salary and so on when you plan to leave later.

To commend Russia graduate as ‘incompetent’ is not solely from what we think. It is from what we see and how they all perform when they are doing attachment in Malaysia. We as senior doctor don’t see only the knowledge but importantly the way and idea of how to look for the important patient history, come to the provisional diagnosis, ordering necessary tests and your approach later to solve the patient problem.

Knowledge you can learn from the books as we all don’t expect you know top to toe of each diseases. We senior doctor sometime have to read back our undergraduate book as well. So, the thinking and the approach of how you search and prioritise the patient problem when you see each patient is my utmost concern.

Sorry to say that the russia graduates that I seen so far is not up to the respective standard. They’re more concern of how to do T&S, dialysis and procedure but neglected the basic science and the correct approach to the disease. Skill can learn later but when you have wrong approach from the first place, it is very very hard for you to change later.

Adaptation from one health care system to the other health care system is no problem as if your approach is right in the first place. You can survive in both places. For example, russia student that I saw couldn’tt tolerate the synonym that used in Malaysia. Example CXR and chest x ray, AXR and abdominal x ray, Rx and treatment, Ix and investigation. I don’t know why they are so insist of using the full sentence. It is just a media for us to communicate with our college. What we concern is your approach, approach and approach.

Don’t expect to change the recent health system overnight as I believe that our DG and superior are doing hard work in changing it. You just can’t expect that you only come back when everything is ready for you. You have to sail through the hard time of how the system change and witness it.