Wednesday, 23 January 2013

Becoming a Family Medicine Specialist in Malaysia

Lately a few friends have approached me with regards to becoming a Family Medicine Specialist in Malaysia. I hope the information here will be beneficial to all.

Although General Practitioners (GP) have been around for the longest time in Malaysia however, the recognition and training of Family Medicine Specialist (FMS) in Malaysia is a relatively new and began in 2003 or so.

The rules with regards to opening a private GP clinic in Malaysia has not yet changed although there has been some talks and attempts to ensure that future GPs will have some form of accredited training prior to working in General Practice. On the ground level, more and more new GPs are taking their own initiative to receive training in the field of General Practice.

I guess this is due to various reasons. With abundance of MBBS graduates being churned out per year...doctors are becoming aware of their need to specialise and to attain a postgraduate qualification. Modern medicine is rapidly changing. Research in the field of medicine is growing ever so fast and there are more available grants. Even I am involved in research...so that says something!

Patients are also becoming more health concious and aware of the new advances in medicine. The concept of patients 'blindly' following doctor's instructions are slowly shifting to a more 'patient centred approach'. Hence, there is an increase challenge for doctors to keep up with new medications, new treatments and new approaches in communicating to patients.

It is no longer acceptable for doctors to practice convenient medicine and continue in their management of patients based on their 30 years experience. Experience is no doubt exceptionally valuable and nothing can replace a highly experienced doctor. However, the educational component, structured learning and mentoring process of the postgraduate training is vital in ensuring a high clinical standard of all doctors and create a passion for life long learning. The exposure to different specialties is extremely valuable for GPs in order to equip them with the ability to diagnose and manage multiple complaints of various systems and origins.

To become an FMS or primary care specialist in Malaysia you need to have a postgraduate degree in either MMed Family Medicine, FRACGP or MRCGP.

MRCGP training is in the UK and it is a structured 3-year training programme. Although there is MRCGP [International] which candidates can sit for in various countries including Brunei, Sri Lanka and others. However, there is no structured training available, it maybe expensive and the passing rate is relatively low.

Candidates may enter the Diploma in Family Medicine (DFM) training conducted by Academy of Family Physician Malaysia (AFPM). The DFM is a 2-year part time structured course with examinations. After completing the 2-year DFM candidates may opt to continue with the Vocational Training Scheme (VTS) and sit for the MAFP/FRACGP which is a Malaysian/ Australian General Practice professional examinations to become a member of the Australian Royal College of General Pracitioners. At present, candidates who sit for this exams may also work in Australia.

Candidates may choose to join the Masters in Family Medicine training which is currently offered in University Malaya (UM), University Kebangsaan Malaysia (UKM), University Sains Malaysian (USM) and University Teknologi MARA (UiTM). This is a 4-year full time structured training with research component in year 4. This is an excellent programme and suitable for those planning to go into academic, teaching and research within a University setting or to work in the MOH Health Clinics.

We are seeing more GPs even those who have been practising for many years joining the DFM programme and venturing into FRACGP. We are also seeing more applications for the Masters in Family Medicine training. I believe even without the pressure or law by the MOH the trend is for future GPs to have postgraduate training and qualification in General Practice.

48 comments:

  1. Hi, I am a foreign doctor presently working as lecturer in a malaysian PVT university.I m fully registered with a foreign med council but recently MMC rejects my registration application.Is it possible to continue without registration for vocational training sccheme of AFPM,if i complete their DFM course?

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    Replies
    1. Hi, thanks for visiting my blog. With regards to your question, I know without MMC registration drs are not allowed to do clinical practice in Malaysia and it maybe a requirement that you do clinical sessions in order to undertake the DFM course but it is best for you to contact the AFPM directly. Please click on the webpage above for their contact details. All the best.

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  2. Hi, my name is Ickes. I am a Malaysian who is studying my final year of MBBS in Australia currently. I hope to receive my further training after internship in GP Training programme to obtain FRACGP, and would go back to Malaysia to open my own private clinic. Would I be considered a Family Medicine Specialist and would therefore receive the license to open up a private clinic without having the need to receive more training/exams?

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  3. Currently only those with MMed Family Medicine, MRCGP and FRACGP are considered as Family Medicine Specialist in Malaysia. All the best!

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    Replies
    1. salams..
      Hi there...for Malaysian Doctors with MRCGP (Int), are they considered as FMS in malaysia
      ?

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    2. Wslm. The most important thing is the specialist training e.g. in UK, one is not considered a general practitioner unless they go through the VTS training scheme and MRCGP is now part of the exit examination. Masters in family medicine in Malaysia go through 4 years of training post and those sitting for FRACGP have to do 4 years of online training with courses. To be considered FMS, you must prove training and not just exam certification. However, best to confirm with National specialist register (NSR) Malaysia.

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  4. Nice article!
    I've shared it in Dobbs, the Malaysian medical doctors forum as someone asked about FMS training.
    The topic is located here (login required for registered Dobbers):
    http://forum.mydobbs.net/groups/dobbs-general/forum/topic/family-medicine/

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  5. Very good article. Simple yet informative. Just to correct a few points. The DFM is an ONLINE part time 2 yr course with 8 weekend workshops. After passing DFM, candidates can pursue ATP (Advanced Training Programme, No more VTP) also a 2 yr part time course with monthly mentoring. ATP also has a Research component. All ATP Candidates must be a practicing GP before he/she is allowed to sit for the MAFP/FRACGP Exam. However there are certain criteria to meet and all applicants will go through the AFPM Censorship board.
    Yes FRACGP holders are considered as Clical Specialists but only after finishing an 18 month gazettement with the govt.
    MAFP/FRACGP Exam is now held twice a year in Kuala Lumpur and is a Conjoint Exam between Msia and Australia.Those who passed can work in Aust New Zealand, Spore, Brunei and of course Msia.
    Dr Rohaya Masod
    AFPM

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    Replies
    1. Thank you very much for your comment and corrections. Much appreciated.

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    2. This comment has been removed by the author.

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    3. Hello Dr. Mas, could you elaborate a bit further on the competition of places for the DFM and ATP? What gives prospective candidates the edge in getting into the programme?

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  6. hi there
    i love to read ur blog...ifeel enjoy reading about your adventure in england..
    how i wish to b like u =)
    actually i wanted to ask ur opinion...about being a specialist..
    do u mind if i email u personally..


    ReplyDelete
    Replies
    1. Sure. You can find my email address here http://littlemuslimstories.blogspot.com/p/dear-parents.html

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  7. Hi i am non malaysian (Pakistani) and have done MCPS Family Medicine from CPSP Pakistan and my husband has done MRCGP (Int) . Kindly guide us how can we get a job in Malaysia.We will be very greatful .

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  8. Dear Dr Rabab, yours is a difficult question to answer. First of all, you need to be registered with the Malaysian Medical Council to practice in Malaysia. You will go through a vigorous process of validation. At present, to be considered as FMS in Malaysia is only via the local Masters programme (MMed), FRACGP (Australia) or MRCGP (UK). For MRCGP, you need to have undergone the training in the UK.

    My suggestion is for you to contact the Malaysian Medical Council first. It maybe possible for you to approach individual private universities to work as an academician depending on their selection criteria. However, without the MMC registration you will not be able to do clinical practice. Hope all works out for you.

    Any clarification from Dr Mas or others are welcome and appreciated. Thank you.

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  9. Hi theere, thank you for sharing your personal thoughts and experience with your relocation process back to Malaysia. I am a Malaysian who has been working in Singapore for 8+ years now and I am currently seriously considering of coming back home to practise.
    I work as a GP now in a private medical group in Singapore. I have been looking through the MMC website for application details and I have a few questions regarding registration as Family doctor in Malaysia. I will really appreciate if you , or any one here can shed some thoughts on my questions.

    1) The total length for compulsory service for doctors is 3 years unless you have worked 10 years overseas before relocating. Hence, for someone like me who have worked 8 years plus, will I still be subjected to full 3 years of service or will there be any 'pro-rating' or adjustment of the duration based on my years of practising?
    2) If I do need to serve, will I be sent to Government clinic as Primary care doctor or do i need to go through a few hospital postings as well?
    3) I have a Graduate Diploma in Family Medicine ( Singapore) and I am considering taking up Master in Fam medicine Singapore, but seems like MMC may not recognised this as a postgraduate qualification. Am i right to say so?

    Sorry for the long winded questions, but i have tried to get more info from web without any luck. Hope some kind souls here can give me a hand. Cheers

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    Replies
    1. Thank you very much for your query and apologies for the delay in reply.
      1. Regarding compulsory service, so far the conditions remain the same except if you can prove that you are in a rare much needed specialty which includes family medicine and myself have been given the 3 years exemption however, I have chosen to stay in academic/government.

      2. You may serve in either KKM (clinics/hospital) or public and possibly even private universities.

      3. So far the National Specialist Register only recognizes Local Masters Programme, FRACGP (Australia) and MRCGP (UK). There is no one yet who has been excepted with a Masters in Fam Medicine from Singapore unless I am mistaken. You may benefit by contacting the National Specialist Register in Specialty committee of Family Medicine
      http://www.nsr.org.my/
      email nsr@nsr.org.my



      Would appreciate comments/corrections from others.

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  10. I received an email from a GP from the UK enquiring about working as an FMS in Malaysia. Unfortunately, the email got deleted accidentally and I apologize for that. I hope the Dr would read my response here.

    I can only respond from the viewpoint of government (public) university here in Malaysia. If you have the MRCGP qualification then you have the option of working as a clinical lecturer. We have many overseas Dr working on a contract basis with our faculty but mostly in other departments and not primary care. However, if you intend to do clinical work as well, you will have to apply for MMC registration. (Malaysian Medical Council)


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  11. Dear doctor,

    Thanks for sharing your experience about relocating home from UK. I am a Malaysian dortor working in Uk since my graduation in 2000. Due to family circumstances at home, we are thinking of going back home to be closer to our ageing parents. I would be grateful for you assistance.

    1. What is the waiting time for MMC registration? (assuming you have all you paper work ready and in order)
    2. You mentioned that you were eligible for compulsory service exemption - how difficult was the process?
    3. Also, the compulsory service exemption (below 45ys) is only for 'rare speciality' - and that family practise was one of them. Do you know what is included in the 'rare specialty'. I have MRCPCH, and work as an Asso Speclialist in Paed Cardiology

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    Replies
    1. You are most welcome. Regarding your queries:
      1. The waiting time hopefully have improved since 3 years ago but from handing in your forms to actually getting the MMC number may take around 3 months depending on how straight forward your application is.
      2. When you fill in the forms, there is one part where you can tick if you are applying for exemption from compulsory service and why you believe you should be exempted.
      3. I am unsure about MRCPCH, you could email me at farari74@hotmail.com and I could pass on your email to a friend who is a consultant paediatrician in Sime Darby Medical Centre. He returned from UK recently. He might be able to advise you.
      Hope this helps.

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  12. Salam dr....im malaysian doctor.working as medical officer in health clinic for 2 years.interested to pursue with dip fms n ATP....need some motivation words...:-)

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    1. Wsalam,
      Congratulations for expressing your interest in pursuing DFM + ATP. Current Drs are certainly encouraged to pursue specialty training especially within this current climate of competitiveness. The DFM + ATP programme conducted by the Academy of Family Physicians Malaysia (AFPM) is a recognized training programme and is highly recommended for those intending to work as FMS in Malaysia; as well as the Masters in Family Medicine.

      However, like any specialist training the journey may seem arduous but with guidance, hard work and enthusiasm...four years will fly by before you know it insyA. So, if this is what you want then go for it! All the best.

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  13. Hi Doctor
    I have MRCGP uk with CCT, and on GP register of GMC and has almost 5 years of experience working in London. I also has FRCS Ire and FRCS Ed.
    How and where I can find the FMS jobs in Malaysia.. I am a UK national, but bring my family up in a Muslim country.
    I will appreciate your help.
    Babar Agha

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  14. Hi Doctor
    I have MRCGP uk with CCT, and on GP register of GMC and has almost 5 years of experience working in London. I also has FRCS Ire and FRCS Ed.
    How and where I can find the FMS jobs in Malaysia.. I am a UK national, but bring my family up in a Muslim country.
    I will appreciate your help.
    Babar Agha

    ReplyDelete
    Replies
    1. Thank you for expressing your interest to work as FMS in Malaysia
      All locals and foreign doctors must register with Malaysian medical council (MMC) in order to do any clinical work in Malaysia. This is similar to the GMC in UK.
      Without registration, you may find work as academician which involves teaching medical students and research. You may approach any of the local public / private medical schools and inquire for jobs. In UiTM we have been approached by UK nationals interested in becoming FMS lecturers.
      A few things to bear in mind, although Malaysians understand English but most prefer to speak in Malay or other races will speak own language e.g. Cantonese, Hokkien, Tamil etc…
      Also, maybe a good idea for you to come and spend some time in Malaysia if you haven’t already. Although majority are Muslim but Malaysia is far from implementing Islam as a whole. Also, it is very different from the UK in culture and mentality.

      Hope this helps. TQ

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  15. salam dr far Ari..

    tq!! very informative article!! just at the time that i need it!!

    in fact, I just made my mind about it then undecided again after I met with my FMS today pm! sigh..still in doubt (vs malaysian masteR prog) at the moment but then I just realized that I should just proceed with this dfm prog first! couldn't wait longer till my kids all grown up and I lost interest to further my knowledge :c need extra support here! c:

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    Replies
    1. TQ for expressing your interest in becoming FMS. Certainly, if you prefer a more flexible route dfm is a better way to proceed. The masters program is very intensive and for the next four years, you will have to be mentally prepared to take up the challenge. However, you survive knowing there's light at the end of the tunnel. Good luck to whichever path you wish to take.

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  16. dear dr,

    if i am a private gp who has quit government and pursue the academy of medicine fms prog...must i join the government back for gazzetement?

    thank u in advance and great blog sir!

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    Replies
    1. Dear Dr, you will need to go through the 18 months gazzattement in order to register as a specialist with the NSR. My suggestion is that you contact the NSR https://www.nsr.org.my/
      You do not need to rejoin government, the gazzattement is done at klinik kesihatan, at present once a week.

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  17. dear doctor , if i had quit the government service and i posses a frcagp ...must i join the governtment for gazzettement?

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  18. As salam dr far Ari
    Just wanna know, is there any entrance exam we have to sit to be accepted into malaysia master fms program? Hows the format? Mcq?essay? Covering basic science? Or general practise?

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    Replies
    1. Yes, there is an entrance exams. You will need to apply through KKM (if you are a KKM candidate) or approach one of the universities providing training under conjoint if you intend to do masters as a trainee lecturer of that university. At present, the universities providing MMed (Family Medicine) are UM, UKM, USM, UiTM, UPM and UIA.

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  19. every country has an exam which to become a doctor so you need to clear that than after you can become a doctor.

    Singapore specialist doctors

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  20. dear doctor,

    how can I work in Singapore or Australia if have master qualification in family medicine under local university?
    can I sit for frcagp as well?
    thanks.

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    Replies
    1. Dear Night Crawler,
      I am not sure about Singapore but if you are eligible to sit for the conjoint FRACGP/MAFP then, those who have that qualification can work in Malaysia and Australia as family medicine specialist. You will need to find out from the qualifying body regarding the process. Thank you.

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  21. Hello Doctor,
    I am one year mo in klinik kesihatan
    I want to do FMS,
    I want to apply for master programme.

    1.Staying in kkm which hospital/ univ I can apply?
    2. I heard have to prepare some exam before get masters ?
    3. What books or what subject I need to prepare for that exam to enter master programme?
    4. Do I need any recommendation from my HOD?
    5.how long will be the duration of doing master in FMS?.. Is there anything such as ‘part time master.?

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    Replies
    1. Hi there.
      1. You can apply through KKM and give your university of preference.
      2. There is an entrance examination which is an MCQ.
      3. Very difficult to answer.
      4. Not sure. You need to check with KKM with regards to application to join masters program.
      5. Masters program is for 4 years. There's no part time but maximum time to complete is 7 years e.g. for those who has to take maternity leave etc...etc...

      All the best.

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  22. Thanks for the informative blog!
    I'm a GP at private clinic. After pursuing FRCAGP, gazattement would be done at klinik kesihatan, is it? How frequent per week? We need to get permission only from FMS klinik kesihatan before gazattement?

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    Replies
    1. From my understanding, after FRACGP in order to register with National Specialist Register (NSR) you have to do 18 months gazettement at Klinik Kesihatan under an FMS. You need to go to NSR website, apply with photocopy of required evidences. They will send you a letter to inform you of how to complete your gazettement. You can choose from the list of KK. I suggest get in touch with NSR.
      Good Luck!

      Delete
  23. Hello and thanks for this post.

    I'm currently a medical student hoping to specialise in GP here in the UK. I'm slightly worried that getting an MRCGP here will not be very useful if I decide to go back home to Malaysia. After reading your post though, it seems that it won't be wasted time after all (thankfully).

    Is there a big difference in responsibilities between a family medicine specialist and a GP in Malaysia? Or do they do the same thing except with an additional qualification?

    Thanks!

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    Replies
    1. Hello there Leto,
      Yes, MRCGP from UK is a good qualification to have if you intend to work as an FMS/GP here in Malaysia. When you return to Malaysia, you will have several options. You could:
      1. Join MOH and work at Klinik kesihatan. the working hours are from 8am - 5pm although some KK have extended hours.
      2. Join university (private or public) and be a FMS lecturer/clinician.

      the responsibility are in principle the same although there are differences in system. You have to bear in mind that UK is one of those countries that have a National health service and GPs are 'gate keepers' to the health service meaning a patient cannot see a hospital specialist without first being referred by the GP. Malaysia has a two tier system of public and private; hence...the role of GP/FMS as gate keepers is not so clear cut. that I find is the main difference.

      As far as clinical work is concerned, Klinik kesihatan has a nice working atmosphere although workload is heavy. Even if you choose to go private or academic, with MRCGP you still need to work once/ week in KK for your gazettement so you will have that experience.

      All the best.

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  24. hello Dr Far Ari... I'm interested to take MRCGP in UK by next year... Currently i'm still working in Malaysia govenment hospital...How can i persue with MRCGP in UK? how to i register?

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    Replies
    1. Perhaps you do not understand that MRCGP (UK) like Masters in Family Medicine Malaysia is NOT simply an examination, it is a training program. You need to be in the 3 or 4-year training program in order to sit for the MRCGP (UK).
      My suggestion is if you intend to sit for an overseas recognized qualification for family medicine, you should go via the DFM / FRACGP (Malaysian - Australian) exams which is conducted by Academy of Famly Physicians (AFPM) You can find out via their website. http://elms.afpm.org.my/portal/
      At present, there is no short cut to becoming a specialist. You must go through training first. Hope that clarify matters. TQ

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    2. Yes, there's no short cut to Family medicine Specialisation.
      I have just created a web site for those interested to know more about DFM, ATP and the MAFP/ FRACGP Exams. Please click http://drrohaya.com

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  25. Hi. I have been working as a freelance locum officer at various private clinic and hospital. Just wondering whether I will be accepted into the DFM programme since my working duration as a freelance locum is less than a year. Kindly comment

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  26. Hi please refer to the application criteria from the AFPM website.
    http://elms.afpm.org.my/portal/diploma-in-family-medicine
    - go to download more information on DFM and you will find the criteria. You can also email them for further details.
    All the best.

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