FOLLOWING revelations of the extreme shortage of cardiothoracic surgeons in Malaysia, the number of urologists serving the population has also been deemed inadequate.
Malaysian Urological Association (MUA) president Dr Noor Ashani Md Yusoff said 33 urologists are presently serving in Ministry of Health (MOH) hospitals while another 18 are in teaching hospitals nationwide, but this number is not adequate.
A conservative ratio would be one urologist to 200,000 people or 165 for a population of 33 million he said.
In fact, we should be aiming for one urologist per 150,000 people as our next target, he added.
"Our Asean neighbours such as Singapore, Thailand, Philippines and Vietnam have more urologists per ratio of their population."
Dr Noor Ashani said in total 139 qualified urologists are currently registered with the National Specialist Register (NSR) and they are also MUA members.
Another 39 clinical urologists are under the Parallel Pathway Programme (for training of medical specialists) at various stages.
Commenting on the issue of medical specialists training under the Parallel Pathway Programme, Dr Noor Ashani said if the Malaysian Medical Council fails to recognise those qualifying as specialists through this programme, it will impact the career and livelihoods of these doctors.
Furthermore, in the field of urology, the Parallel Pathway Programme is currently the only means for doctors in Malaysia to train and specialise in urology.
There is no alternative local Masters of Urology programme, stressed Dr Noor Ashani.
As a result, if the parallel programme is not recognised, there will be no urologists trained anymore until we are able to establish a local urology training programme.
"This will impact the expansion of urological services within MOH. It will not be possible to open new services in Peninsula, Sabah and Sarawak. Moreover, without future urologists, it would be very difficult to sustain existing urology centres."
Some urologists may retire soon, he added and the continuity of services is vital for the good image of MOH and the government, he added.
Malaysian Family Medicine Specialists Association president Dr Nor Hazlin Talib is in agreement with Dr Noor Ashani on the need to continue the Parallel Pathway Programme for training of medical specialists.
By 2050, Malaysia would require 8,000 family medicine specialists (FMS) or 1 FMS per 4,000 people to provide equitable healthcare to its expanding population of over 32 million, she said.
However, there are now only about 1,300 FMS in the country, with the majority working in government-funded healthcare facilities.
The local Masters Programme produces approximately 100-150 FMS per year, while the parallel pathway produces approximately 200 FMS every year.
"To achieve an optimal FMS-to-population ratio, both the parallel pathway and the local Master Programme must persist, complementing and reinforcing one another," she said.
Family medicine is a medical specialty that provides coordinated, continuous, and comprehensive care to both individuals and families.
It is the foundation and driving force of primary care and primary care is essential for health promotion, early identification, treatment, rehabilitation, and palliative care.
The shortage of medical specialists in Malaysia has also been highlighted by the Malaysian Medical Association which has pointed out that there are less than 13,000 specialists serving the country, with only around 9,000 serving in public healthcare despite over 70 per cent of the population depending on public healthcare.
On Feb 6, Malaysian Association for Thoracic and Cardiovascular Surgery (MATCVS) president Datuk Dr Basheer Ahamed Abd Kareem had stated that the long waiting list for life-saving heart surgery at all seven MOH cardiothoracic centres nationwide would result in the death of one patient from each centre every week.
He said Serdang Hospital (now known as Hospital Sultan Idris Shah Serdang) and Penang Hospital each have more than 1000 patients on their waiting lists, with the waiting time for surgery expected to exceed a year. Meanwhile, around 300 patients are on the waiting list of each of the remaining five cardiothoracic centres in the country and the situation is critical.
He stressed that the decision by the MMC to reject specialist registration applications for the National Specialist Register by four pioneer Cardiothoracic Parallel Pathway graduates would pose a great danger to the running of critical cardiothoracic surgical services within MOH.
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