POST-GRADUATE MEDICAL EDUCATION AND EXAMINATIONS MEDICINE is an ever advancing discipline with new-discoveries, new ideas and new techniques being introduced continuously. Post-graduate medical education has to be a continuing process if our doctors are to keep abreast with the phenomenal advances in medicine. A certain amount of self-education is undertaken by doctors who pursue some of the ever-growing output of medical literature. Organized facilities are provided by Medical Associations and Societies, large hospitals and teaching institutions in the form of clinical meetings and lectures by eminent clinicians and research workers. These activities, however, are confined to the larger towns and only relatively few of the busy practitioners take full advantage of these opportunities. There is need for extension for this programme by providing better facilities in the form of lecture halls, facilities for the projection of medical films and tape recordings of lectures at a time and place best suited for most of the practitioners. This is an age of specialization and to supplement the activities of the MMA, the Academy of Medicine and the University of Malaya there have come into being Organisations to cater for the special needs of surgeons, physicians, obstetricians and gynaecologists, general practitioners, oto-rhino-laryngologists, ophthalmologists, anaesthesiologists, psychiatrists, pediatricians, radiologists, urologists and the like. Some of these Organisations are designated Colleges, and in addition to providing the facilities for keeping their members informed of advances in their particular fields they are talking of conducting examinations in their specialties and awarding diplomas and degrees rather like those granted by the Royal Colleges in Britain and Australia. It has been, and to large extent still is, the practice for Malaysian Medical graduates to go abroad to UK, Australia and USA for post-graduate studies. This is not an altogether satisfactory arrangement because of the differences in culture and disease patterns in these foreign countries. Besides, it is a costly undertaking involving traveling with or without their families and maintenance problems. It must be remembered that these trainees during their period of apprenticeship render considerable service to the hospitals and the people of the countries where they study. This is a great loss to Malaysia with its insufficient medical manpower, and every effort should be made for our graduates to obtain their post-graduate training locally. Some effort has been made to reduce the time they have to spend abroad by instituting a training programme during their registrarship in the big hospitals and laboratory postings at the Institute for Medical Research. This, however, is inadequate to serve our purpose. While advocating training locally, it is not suggested that a visit abroad is not desirable. In fact, it is necessary to give our graduates the breadth of view which can only be obtained by brief visits to centres of advanced learning. The best time, when they are most likely to benefit from such a visit, would be after our doctors have obtained post-graduate experience and degrees locally irrespective of whether the post-graduate examinations were held under the auspices of the Royal Colleges or not. At the moment, the Institute for Medical Research, Kuala Lumpur, is the national centre for training and research of the Central Coordinating Board for Tropical Medicine of the Southeast Asian Ministers of Education Council which has been conducting post-graduate courses leading to the Diploma in Applied Parasitology and Entomology. The Board on Post-Graduate Medical Education has started at the University of Malaya courses for the Diploma in Public Health, Pathology and Psychological Medicine. It is contemplating running courses in Paediatrics and Obstetrics and Gynaecology. The Board on Post-Graduate Medical Education has also arranged for the holding locally of examinations of the Royal College of Physicians, Surgeons and O & G of UK and Australia and short courses have been held in the Faculty of Medicine, University of Malaya in preparing candidates sitting for these examinations. For running these courses, the Board has been almost solely dependent on the staff of the Faculty of Medicine, University of Malaya, whose terms of appointment include teaching at the post-graduate level as well. There is no doubt, however, that there are a number of specialists in government service, in the Universiti Kebangsaan and in the private sector who are fully competent to teach at the post-graduate level and whose services are not utilised at the moment. Perhaps, the situation can be remedied by setting up a new Board on Post-Graduate Medical Education with powers to requisition the services of all available talent in the country. As at present constituted the personnel of the Board is practically solely drawn from the Faculty of Medicine, University of Malaya with the Dean as Chairman. The new Board can be set up as an independent Statutory Body with better representation from the Faculty of Medicine of Universiti Kebangsaan, the Ministry of Health, the Academy of Medicine, the MMA and other interested organizations. Such a body could be held responsible for planning all post-graduate medical education in the country taking into consideration the future needs of the country and making full use of the resources available. Besides determining the specialties in which training could be developed locally and where courses could be best conducted, the Board could decide on the disciplines in which post-graduate examinations are to be held in the country. The question of our ability to maintain adequate and comparable standards at local examinations should be seriously considered lest our graduates suffer from an inferiority complex. It is not desirable that every 'College' that considers itself competent to do so should automatically be entrusted with the power to hold post-graduate examinations and award diploma and degrees.
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