MANY young Malaysians aspire to become doctors. However, only some will get to pursue their dreams. We have surpassed the World Health Organisation (WHO) recommendation of one doctor to 500 patients. Currently, the doctor-to-population ratio is about one to 454 patients.
There are 38 institutions in Malaysia offering medical courses, producing between 3,500 and 5,000 medical graduates annually. The country's 39 public hospitals could not offer all new graduates houseman training for one to one-and-a-half years.
In response to this "oversupply" of new housemen, the government has frozen the establishment of new medical institutions from 2011. Although there is an "oversupply" of medical graduates, Malaysia faces a chronic shortage of medical specialists. In 2017, there were just over 7,000 specialists.
To shorten the waiting time for houseman postings and offer more specialist trainings, the government has taken steps to expedite several hospital-building projects. Attempts to increase the number of housemen and post-graduate medical training in public medical institutions will require huge amounts of financial and human resources.
The ongoing disruptions created by Covid-19 will further strain the financial position of the government. The solution is to enable private medical institutions to establish their own teaching hospitals. There are several reasons supporting such a solution.
FIRST, they will ease the demand for housemanship and post-graduate training in public hospitals. It will improve the student-patient contact time and enhance learning. Patients will also have more time to rest. This will facilitate recovery from illness.
SECOND, private teaching hospitals will create job opportunities for house officers and other healthcare professionals while considerably cutting waiting time for housemanship postings. More doctors and specialists will be made available to meet the country's healthcare needs.
THIRD, about 70 per cent of a medical student's time is spent in hospitals interacting with patients and staff. Healthcare professional students are able to use both government and private teaching hospitals facilities, thus reducing the patient-to-student ratio, which will be good for the patients and will enhance student learning experience.
Students will have more quality time interacting with patients to learn soft skills, including communication skills, physical examination techniques, learn the art of diagnosis, discuss clinical management and follow up on the outcome of treatment. This also helps students to develop a sense of medical professionalism.
FOURTH, private medical institutions with teaching hospital facilities have better control over the teaching arrangements in those hospitals. Coordination
between all the hospital staff in different service areas can be achieved with the aim of providing good patient care and facilitate medical education.
Medical students will have more opportunities to learn through the healthcare system by observing and participating in patient care. Most importantly, in such an environment, medical students will develop a sense of belonging.
They will internalise the noble mission of care for patients. The provision of private healthcare services will also create the opportunity to generate new sources of revenue for these private teaching hospitals by way of private-paying patients, post-graduate specialist-training programmes and research work.
FIFTH, universities that offer other healthcare professional courses will benefit even more if they have their own private teaching hospitals. Nursing and other allied health courses will share the training facilities in the hospitals. Job opportunities will be created for their graduates, allowing the universities to create a competitive advantage in the business of the provision of healthcare education.
Students pursuing business, engineering, information technology and other fields will have a hands-on opportunity to learn in a hospital environment and future job opportunities. This will surely add value to the training.
The provision of private healthcare education is very competitive in Malaysia. In order to be world class, sustainable and profitable while producing excellent healthcare professionals, private universities have to think long-term.
They will have to either improve existing or establish new teaching hospitals. Such a move should include establishing advanced clinical simulation facilities to enhance skills learning for both undergraduate and post- graduate students.
The race is on for private medical schools to build their own hospitals. No institution would want to be left behind in creating a sustainable business.
The writer is associate professor and director of the Clinical Skills Centre, AIMST University Malaysia