On Professional Practice Registration & Others (by Dr JB Lim)

Dr JB Lim

The blogger’s note: In response to Ir. Tan Seng Khoon’s query on medical doctors’ registration to practice as reproduced below, Dr JB Lim wrote another lengthy albeit interesting email.

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On Wed, Jul 10, 2013 at 9:44 AM, Tan Seng KhOOn wrote:

Ju Boo,

You are absolutely LIngam.

I earlier had the wrong impression that a doctor needs to sit for a professional exam so as to qualify to register with MMC and then TO PRACTICE MEDICINE.

So registering with MMC is AUTOMATIC for all doctors graduating from RECOGNIZED medical university.

Not so for Engineers.

Graduating engineers must be from recognized University to register with Board of Engineers (BEM).

The IR title is not automatic.

Graduating engineers MUST PASS A PROFESSIONAL EXAM to qualify for registration with BEM, before he is awarded the IR title.

Only then can he be called a PROFESSIONAL ENGINEER and can PRACTICE ENGINEERING.

It is more strict.

Rgds,

Khoon

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Th, 11 Jul 2013 at 0:0112:01 AM

FROM: lim juboo

Dear Learned Ir. Khoon,

I think you cannot apply your engineering rules and regulations and expect all other professions to follow the same. Each profession sets their own laws according to their needs and requirements

As for the medical profession they take the university as the qualifying body, and the MMC is just a regulatory and licensing board to allow medical graduates to practice medicine. The MMC has now power to train, educate or to graduate a medical student. MMC is not a training school for students to become doctors. This power is only given to a university or a medical college.

MMC is still under the Ministry of Health (MOH) and all matters pertaining to any health practices in this country as required by recently enacted laws, be it the practice of medicine, dentistry, pharmacy, nutrition, dietetics, alternative and complementary medicine, traditional medicine (Chinese, Malay or Indian) comes under the MOH and not the MMC.

All medical and allied-health practitioners MUST be registered and licensed before they can practice in this country. It used to be "free for all" but not now because of unqualified people around like beauticians, bomohs, and fortune tellers who may jeopardize public health when they are not even educated let only holds a degree in medicine or in any of the allied health sciences.

So the government has no choice but to regulate all the allied-health professions (medicine is just one of them) to ensure that all the practitioners are qualified, their degrees recognized, and they can be registered for practice.

We had countless meetings after meetings for years, and even long after I retired over this issue when I was still working at the Institute for Medical Research (IMR). I was then one of the members of this special regulatory committee, a joint WHO / MOH Select Committee to oversee how best we can implement these regulations (which has recently been passed by Parliament to become Law).

We had a lot of difficulties over these, as there are now so many allied-health sciences besides medicine offered by universities all over the world, including those in Britain, US, Australia, Canada, Europe, China, India, etc. All these universities do offer well meaningful 4-6 year degree courses in health and medical sciences, from clinical nutrition and dietetics to speech therapy, down to alternative medicine of various systems. And they are recognized in their own countries for practice after graduation, but they too must be registered to get a license.

So it took us in the government to sort all these problems out, which of course was a very mammoth task. We had representations in the committee from the MMA, MMC, Nutrition Society, Malaysian Dietetics Association, local universities, university hospitals, various professional bodies in health sciences, etc, etc.etc.

It was very difficult for us to come to some kind of agreement how to regulate all these health and medical professions. It was no more like 60 years ago where only the medical doctor treats a patient. Now you have even well qualified clinical psychologist who holds a 3-4 year degree from a recognized university treating mental patients taking over the place of psychiatrist, or a qualified doctor in Traditional Chinese Medicine holding a university degree after 5-6 years training from China who are as good if not even better than a doctor trained in mainstream medicine in treating difficult cases which western trained doctors cannot handle.

These doctors of alternative systems of medicine are good, really good, and we cannot ignore them anymore. I know of many doctors even using alternative medicine to treat their patients. At least 5 of my medically trained colleagues use alternative systems of medicine to treat their patients after they left Government Service. Some even went for courses in alternative medicine as well.

Hence the World Health Organization has recommended governments all over the world (including Malaysia) to integrate all these health care systems into the mainstream health system in the country. It was a very, very difficult task because of existing medical laws, educational standards (we follow the British system of education), medical facilities available in government and teaching hospitals, teaching facilities, clinical experience, dialogue with mainstream doctors, etc, etc, etc...endless list of problems.

But they are almost all over with laws now passed to recognize a lot of them officially as health-care professions. The traditional medical profession is just one of them.

So in this 21st Century "professions" are now more confined only to medicine, dentistry, pharmacy, nursing, engineering, law, architect, chemistry (Chemist Act 1975), but much, much more than that...the practice of nutrition, dietetics, optometry, speech therapy, hypnotherapy, genetic counselling, physiotherapy, acupuncture, herbal medicine, psychology, mind-body medicine, etc, etc, etc....All these practices are now recognized as part of the health-care system of this country as the government has passed laws to make them as gazetted professions.

At the moment graduates of some systems of medical practice like Traditional Chinese Medicine, Clinical Psychology, Dietetics, etc can practice in government hospitals, or on their own. They get the same pay and allowances, and same professional status as medical doctors in government service because they are now officially recognized by law as a health-care provider, and as a profession.

But they MUST all undergo recognized training in a recognized university, and they all MUST register with the Ministry of Health to get a license to practice which MUST be renewed every year. There is no escape, because the aim of the government is to upgrade the standard of health care in the country, and to weed out unqualified and BOGUS ones.

I have come across a few cases of BOGUS "nutritionists" who went for a 2 day course in a hotel somewhere in town, organized by some direct-selling health food companies to work for them, and in their calling cards they gave me it was printed there "Chief Nutritionist" and others called themselves "Consultant Nutritionist"

A real qualified professional nutritionist spends a minimum of 4 years after A Levels or HSC in an accredited university to qualify as one (medicine takes 5 years) and not just 2 days in a hotel after LCE to listen to some "training" on how to sell "nutritional products" like "alkaline water" and "reverse osmosis water" (I have no ideas what they are?)

So you can see why the Ministry of Health has to take steps to clamp down on all these BOGUS people, put laws there to regulate the practice of nutrition as a recognized profession like your engineering

You can see the complexities of medical and health-care practices the world over, not just in Malaysia. Now you can also see the new term "health-care professions" or "health-care providers" which was never there before. It used to be just the doctors providing health care. Not now anymore. This world is getting more and more complex, and even we as doctors, physicians, and health-care professionals are slowly being left out and ignored.

It is high time we retire from the scene, and let youngsters take over. But they keep sending me by e-mail, health, medical and nutritional claims I have never studied, researched or even heard before. I felt even more left out than ever by these young BOGUS-ES!

I hope you do now have this sort of problems in engineering, except I heard that developers wants to cut cost by asking the engineers to put in sub-standard products or mix more sand than cement, and force the engineers to quickly sign the building or structural plan before the date line is up.

The other problem I hear is that there are now so many types of engineers (like doctors) - hydro-engineers, genetic engineers, medical engineers, food engineers, automobile engineers, Argo-engineers, electronic engineers, horticultural engineers, paint engineers, computer engineers, system engineers, paper-production engineers, air-con engineers, water-pipe engineers, drainage engineers, water-pump engineers, contract engineers, engineers, engineers, engineers...etc

Don't you too get left out like me at old age? In school I know of only mechanical, civil and electrical engineers. Now evolved all these other engineers above? Are they really engineers? Do they have a license to practice engineering or they too must have own regulatory bodies like health-care professions?

One thing for sure. I almost became an engineer after one of my sister's friend told my sister that I will one day be an engineer because managed to get our old radio in my shop "working again" after I just shook some loose wire connection at the back of our radio.

She visited my sister one day in our shop, and the only entertainment for visitors at that time in the 1950's was just a radio to "sing" out some old songs, and some F& N orange crush for drinks, maybe some cakes and "quachee" (pumpkin / sunflower seeds) or groundnuts. But the radio was not working. So this small boy "engineer" came to help. I just shook the wire at the back and there you are - Mario Lanza was singing old favourites once again.

But before I got married, I was neither an engineer nor a BOGUS engineer. But after I got married, the Female Speaker in my house made me more and more a BOGUS engineer to fix up this, and that for her without any license to practice or license of approval from the town council.

But my sister's friend never expected that I will be a BOGUS one one day after marriage.

jb lim