01 May 2013

Berita Akademi - May 2013

VOL. 21 No. 3

Table of Contents


Message from the Master
Dr Chang Keng Wee

... hospitals tasked with the training were suddenly faced with
too many housemen
and their supervised training...

A new year is upon us again and the Academy Council has crystallized plans for members for 2013. A joint meeting with the Royal College of Physicians of Ireland has been planned for 27th and 28th June 2013. This is to be held in the College grounds in Dublin, Ireland. We hope to discuss collaboration with the RCPI with regard to subspecialty training. There shall be opportunities to visit the training hospitals and discuss with programme heads. Together with this, a holiday tour of Ireland has been planned and the information has been circulated via email. If you require more information, please contact the Academy secretariat. For golfers, a golfing tour is in the mix.

The yearly golf competition with the Academy of Medicine, Singapore is planned for 2nd June
2013. It shall tee-off at the Pulai Springs Resort, Johor. A pre-tournament durian party is planned for the evening before. We look forward to a good showing by members and intend to carry on the tradition of retaining the challenge trophy.

The Academy is proud to be co-organizing the Inaugural TJ Danaraj Oration with the Faculty of Medicine, University of Malaya; in conjunction with its Golden Jubilee Celebrations. This shall be held at the Faculty of Medicine on 10th June 2013. Tan Sri Dr Mohd Ismail Merican shall be delivering the inaugural oration entitled 'Dancing with my Patient: Recipe for Perfection'.

This shall be followed by the (47th Singapore – Malaysia Congress of Medicine on 23th – 24th August 2013. This year's congress shall incorporate the 2nd Tripartite Meeting, where the Hong Kong Academy of Medicine shall participate; and shall be held at the Grand Copthorne Waterfront Hotel, Singapore. It is hoped that academicians from Malaysia will give it their full support.

Much has been said lately about problems faced in the training of housemen. With the influx of new medical graduates; 3714 in 2011 compared to 1534 in 2007, the hospitals tasked with the training were suddenly faced with too many housemen and this has affected their supervised training. It is a pity that there was a lack of co-ordination with the Ministry of Health, when the Ministry of Higher Education decided to approve the registration of medical programmes in 25 universities, 22 university colleges and 5 branch campuses of foreign universities. Medical graduates are not fully registered doctors until they satisfactorily complete their housemanship. This is the most crucial period of the young doctor's life that will shape his/her future career. The Colleges of the Academy are looking into how we can assist the MOH in strengthening standards and come up with an objective assessment of demonstrated competence as an index of completion of training.

The National Specialist Register is in its sixth year. With the amendments to the Medical Act 1971, this shall become compulsory if one wants to practis e as a specialist in this country. This shall now come under the jurisdiction of the Malaysian MedicalCouncil, once the regulations are gazetted. The Academy hopes to continue assisting MMC with this.

The biennial Ministry of Health-Academy of Medicine Scientific Meeting is scheduled for 29th September to 1st October 2013. This year's theme is Ethics in Research. It shall incorporate the National Ethics Conference as well. The highlight for this meeting shall be the Tunku Abdul Rahman Lecture which shall be delivered by Datuk Dr Mahmood Merican, a past-master of the Academy of Medicine.

I heartily encourage all members to actively participate in our activities planned for the year. More details are available in our website: www.acadmed.org.my

Wishing everyone a fruitful year in 2013.

[ Back to top ]

National Ethics Seminar 2012
Better Health Through Ethical Practice
15 July 2012

Y Bhg Dato' Sri Dr Hasan Bin Abdul Rahman
Director-General of Health Malaysia

Presented by Y Bhg Datuk Dr Noor Hisham Bin Abdullah
Deputy Director-General of Health Malaysia

Good medical practice means that Medicine must be practised not only professionally but also ethically as well as legally. These three facets are intrinsically intertwined and have to be observed together at all times. They must not be taken in isolation. A culture of good medical practice must be inculcated and developed, from day one at medical school, and thus, the crucial role that medical schools play in socializing these impressionable entrants to the profession. It is refreshing to note that schools are nowadays are giving more emphasis to the discipline of medical ethics. I sincerely and earnestly hope that the teaching of ethics becomes one of the core subjects in the medical under-graduate curriculum in the future.

Dr. Albert Schweitzer once said, "Let me give you a definition of ethics: It is good to maintain and further life and it is bad to damage and destroy life. What then, are these "ethical principles" that we speak of in medical practice? Whenever we face a dilemma in medical practice, we go back to our ethical principles, i.e. what is considered "right" and what is considered "wrong" in medical practice. An ethical response to a dilemma may be framed in the following terms:

The first principle is autonomy. A competent adult aged 18 years and above has the right to make his or her own decisions after being provided the full information about the pros and cons of the proposed treatment or procedure.

Practitioners have to be made aware that in medical litigations, it is becoming more common for the courts to make judgements in favour of the patients. When it comes to doctors providing full and frank disclosure of information before embarking on a mode of treatment, the onus is on him to take recognise that the more complex the procedure, the greater is the necessity to provide the patient with more details. Just providing information is not sufficient; it must also be provided in a way such that the patient fully understands the risks, complications as well as the consequence and benefits of the proposed treatment. The information provided must in turn be recorded meticulously in the case notes as evidence, if and when dispute arises. In the landmark case of Foo Fio Na, the Federal Court repeated the words of Lord Woolfe in the inaugural Provost lecture: "The phrase "Doctor knows best" should now be followed by the qualifying words "if he acts reasonably and logically and gets his facts right." This is a very reasonable proposition as no patient would want to be treated by anyone who is not acting reasonably and logically and has not got his facts right!

The second principle is beneficience. A doctor must always do good for the patient. The Hippocratic Oath states that "The regimen I adopt shall be for the benefit of the patient, according to the best of my ability and judgement and not for his hurt or for any wrong". This profound statement includes all that is to be said about our absolute responsibility towards procuring benefit for the patient we are treating. Many students wishing to take up Medicine as a career will state that they want to do good for mankind and the community. However, doing good alone is not enough; it must be in the patient's best interest and not what you think is good for them!

The third principle is non-maleficence. A doctor must never harm his patient. If he feels that it is beyond his clinical expertise to treat the patient, it is his ethical responsibility to refer the said patient, as soon as possible, to another professional who possesses the skills and competencies to provide the patient with the care that he needs. It is rather embarrassing to note during inquiries at the MMC that practitioners had to resort to hoarding patients and only referred them when there was no hope of recovery. The excuse given was that the doctor honestly believed that he had the expertise to treat the patient! Belief alone is not sufficient - you must possess the ability and here arises the urgent need for continuous medical education and professional development. Every single practitioner must take it on himself to equip himself with knowledge of the latest developments in the field of medicine that he is practising in so as to serve his patients optimally.

The fourth principle is justice. A patient must be given his rights or dues, especially when others are not deprived of their own rights. This principle particularly refers to resource allocation. In Malaysia, every patient has the opportunity to receive what is thought to be the best for him or her after a clinical decision has been made regarding the process of treatment or care. In the private sector, care is provided on a fee-for-service basis and care is provided based on the ability to pay. If the patient cannot afford care in the private sector, he can always be referred for care in public sector facilities. In the public sector, there are principles based on humanistic values and evidence, as to what sort of treatment is warranted for each patient. But this does not mean that one is denied treatment. Everyone gets treatment based on the resources available.

[ Back to top ]

46th Malaysia-Singapore Congress of Medicine
12 - 14th July 2012
Shangri-La Hotel, Kuala Lumpur, Malaysia

The 46th Malaysia-Singapore Congress of Medicine was held from 12th to 14th July 2012 at the Shangri-La Hotel, Kuala Lumpur. The meeting was co-organized jointly with the Hong Kong Academy of Medicine and the Academy of Medicine Singapore and was supported by the Royal College of Physicians of London and the College of Physicians of Malaysia blending both local and global perspectives to this meeting.

The theme of the 46th MSCM was "Cardiometabolic Diseases: Are We Up for the Challenge?" addressing the current challenges of cardiometabolic health. The Congress was preceded by a Cardiac Imaging hands-on workshop under the College of Radiology. Highlights of the meeting included the 19th Tun Dr Ismail Oration by Tan Sri Dato' Dr Lin See-Yan, the conferment of the Fellowship of the Academy of Medicine of Malaysia (FAMM) to 17 academicians and the induction of 126 new members of the Academy, and also the Young Investigator Award. A trade exhibition was also held at the congress venue. DYTM Raja Muda Perak Darul Ridzuan Raja Nazrin Shah, the Regent of Perak, graced an Opening Ceremony that was filled with pomp and pageantry.

A total of 445 delegates attended the five symposia and four plenary sessions held over two days. The plenary speakers were Professor Dato' Dr Khalid Yusoff (Malaysia), Associate Professor Dr Alice Kong (Hong Kong), Associate Professor Dr Loke Kah Yin (Singapore) and Professor Dr Chin Kin Fah (Malaysia). Other overseas speakers were Professor Dr Duncan Forsyth (United Kingdom), Professor Dr John Wass (United Kingdom), Professor Dr Khay-Tee Khaw (United Kingdom) and Professor Dr Theresa McDonagh (United Kingdom).

Cardiovascular and metabolic diseases including obesity, diabetes mellitus, dyslipidaemia, and hypertension are the leading and preventable causes of death worldwide. The current scenario predicts a dramatic increase in disease burden over the next two decades in the Asia-Pacific region.

[ Back to top ]

Inaugural T J Danaraj Oration

Inaugural T J Danaraj Oration
Orator: Professor Tan Sri Dato' Dr Hj Mohd Ismail Merican
"Dancing with My Patient: Recipe for Perfection"

In conjunction with the
Golden Jubilee of the Faculty of Medicine
Faculty Of Medicine, University of Malaya
10th JUNE 2013, Monday at 1630 hrs
at T J Danaraj Auditorium, Faculty Of Medicine

Tentative Programme

1600 hrs Arrival of guests
1620 hrs Arrival of VIPs
1630 hrs Welcome Address by Professor Dr Adeeba Kamarulzaman,
Dean, Faculty of Medicine, University of Malaya
1645 hrs Launching Ceremony of the T J Danaraj Auditorium by
Y Bhg Tan Sri Dr. Ghauth Jasmon, Vice-Chancellor, University of Malaya
1700 hrs Introduction of Orator by Dr Chang Keng Wee,
Master of the Academy of Medicine of Malaysia
1710 hrs Inaugural Address by Y Bhg Professor Tan Sri Dato' Dr Hj Mohd Ismail Merican,
Pro-Chancellor and Chairman, MAHSA University
1750 hrs Souvenir presentation
1800 hrs Refreshments

[ Back to top ]

Child Rights: Medical, Societal and Policy Perspectives
Press Statement from The Star 5th Sept 2012
Malaysian Paediatric Association and College of Paediatrics,
Academy of Medicine of Malaysia

The judicial outcome of the recent cases of statutory rape has caused public outcry, disbelief and anger. The Attorney-General's Chambers and its chief Tan Sri Abdul Gani Patail (The Star 5th Sept 2012), professionals and lay persons alike have voiced their views strongly in the mainstream and online media.

The Malaysian Paediatric Association (MPA) and the College of Paediatrics Academy of Medicine of Malaysia share these serious concerns that the court rulings may send the wrong message to future offenders. To quote Abdul Gani in the statement "This aberration of justice for those who most need the protection of the law must be rectified".

As advocates of child health and welfare, we continually call upon the society be it the government or nongovernmental organization to address the wider issues of the rights of the child in a comprehensive manner. Regardless whether it is an issue about poverty and child hunger, lack of educational opportunities or a child who has been sexually abused by an adult, then society has failed them.

While many had emphasized on regarding taking concrete actions to prevent and stop violence against children, be it physical, sexual or emotional, it is all too easy to become complacent by concentrating on shortterm goals. We need holistic long term plans to protect the health, welfare and the inalienable rights of the child.

We recognize that the adolescence stage of development is a challenging one with rapid and tumultuous physical and emotional changes. The adolescents may be naturally impulsive in their action. Some are notably argumentative and oppositional, searching for their unique identity. Though most transformation occurs due to their biological changes, it is still guided and moderated by societal norms. They can be nurtured by us; the parents and the society as a whole. As these young people are our country's future assets, they certainly deserve a better deal from us.

What can parents do?

Good parenthood begins with adequate preparation, family planning and child spacing. Positive parenting skills are essential. Children look up to their parents as role-models. Parents must be there for their children, to nurture the young minds and provide unconditional love during this vital period of growth and development. Parents must also be made aware of signs of abuse in their children.

Teenagers out on the roads at wee hours made frequent news headlines. Parents must be held responsible and ensure their teenagers are safe from road traffic tragedies and other high risk behaviours. Under aged children should never be allowed in to pubs and unsupervised in entertainment outlets.

What can our education system do?

Teachers, parents and educators play a key role in educating young children and teenagers on sex education. It is considered a taboo by many in this country to use the word 'sex' except to indicate gender. Instead, schools were told to provide 'reproductive health education'. Be that as it may, there is an urgent need to educate our children on their rights to say 'no' to requests for sex, to respect their bodies and have self-respect, and for all to respect the opposite sex. They must be made aware the importance of abstinence, the health risks of unplanned pregnancy and the consequences of having unprotected sex and sex at an early age.

Information on sexually transmitted diseases and contraception must be freely available. These are medical issues and should be treated as such. Each person may have their personal viewpoints on these issues but the physical and mental health of our children and teenagers are too important to be left to armchair critics and untrained persons in child and adolescent health.

What can our society do?

Can we return to that era of caring (before the advent of CCTV) for each other where neighbours keep watch over each other's children and properties? Perhaps it is an opportune time to go back to the days when 'it took a community to bring up a child'…

Bringing up a child is no easy task, even under ideal circumstances. When a family lives in poverty with lack of community support, it creates a situation in which child mal-treatment are more likely to occur. Many pockets of poverty exist in our community. These situations inflict significant stress on the family unit and sadly, it is the children who receive the brunt of it.

The mass media could focus on preventive measures and advocacy programmes to sensitize our society on the work required to improve the plight and health of our children. It would be ideal for media to work hand in hand with NGOs and professional bodies to champion the rights of the child in our fight against public apathy regarding child abuse and neglect.

What can the government and policymakers do?

Malaysia is a party to the Convention on the Rights of Children (CRC) as well as having the Penal Code and the Child Act 2001 (Act 611) to fulfil its obligation under the CRC. The provisions of Act 611 are based on the four core principles of the CRC that is, non-discrimination, best interest of the child, the right to life, survival and development and respect for the views of the child. Act 611 also provides for a procedure before the Court for Children which is child-friendly taking into account the mental and emotional maturity of a child.

The "reproductive health" curriculum for primary schools was approved with an allocation of more than RM 30 million in 2006. Unfortunately the implementation of the subject has yet to take place.

Child abuse and neglect is a huge economic burden to the country. According to a report released by the Centers for Disease Control and Prevention (February 2012), the life time cost for each victim of child maltreatment who lived was USD 210,012 which is comparable to many major non communicable diseases like diabetes. These include the costs for health care, welfare assistance, special education and productivity loss.

It is also proven by research that child maltreatment can also be linked to emotional, behaviour and physical health problems. It brings on a myriad of problems including aggression, conduct disorder, delinquency, antisocial behaviour, substance abuse, intimate partner violence, teenage pregnancy, anxiety, depression and suicide, as well as future social and marital difficulties.

We wish to end by reiterating two of the major preambles of Act 611: Recognising that a child is not only a crucial component of such a society but also the key to its survival, development and prosperity.

Acknowledging that a child, by reason of his physical, mental and emotional immaturity, is in need of special safeguards, care and assistance, after birth, to enable him to participate in and contribute positively towards the attainment of the ideals of a civil Malaysian society.

Signed by
Dr Hajah Noor Khatijah Nurani
Malaysian Paediatric Association
Professor Dr Thong Meow Keong
President, College of Paediatrics,
Academy of Medicine of Malaysia
Dr Chang Keng Wee
Academy of Medicine of Malaysia

[ Back to top ]

Malaysia-Singapore Annual Inter-Academy Golf Tournament
2nd June 2013
Pulai Springs Resort, Johor

The Annual Golf Tournament between the Academy of Medicine of Malaysia and the Academy of Medicine, Singapore will be held as follows:

Date 2nd June 2013
Venue Pulai Springs Resort, 20KM Jalan Pontian Lama, 81100 Pulai, Johor
Tel: (607) 5212121, 5212222 Fax: (607) 5554848 email: dos@psrb.com.my
Programme 0730 hrs TEE-OFF (1st and 10th Tee) at Pulai Springs Resort
1300 hrs Lunch, Prize-Giving, Farewell and End of Event
RM200 per person
(including buffet breakfast at Gleneagles, green fee, buggy fee, buffet lunch at Ramayana Lounge and insurance)
Accommodation Special rates have been arranged with the Pulai Springs Resort.
  Studio RM236 nett per unit per night
(including breakfast for one or two persons)
  1 Bedroom RM278 nett per unit per night
(including breakfast for one or two persons)
  2 Bedroom
RM418 nett per unit per night
(including breakfast for four persons)

For reservations, please quote AMM-AMS golf and contact Ms Sabrina Lew, Assistant Director of Sales email ados.jbso@pulaigroup.com

The closing date is 10th MAY 2013. Please come and join us for the tournament.

Please call the Academy Secretariat if you need more details:
Tel: 03-4023 4700, 4025 4700, 4025 3700
Email: secretariat@acadmed.my


Emeritus Prof Dat o’ Dr Lian Chin Boon
Organising Chairman


Please also note that we will arrange Durian Party on 2030 hrs, 1st June 2013 at the poolside, Pulai Springs Resort, Johor

[ Back to top ]

Joint Meeting with the Royal College of Physicians of Ireland and Package Tour


27th June 2013 Afternoon – Meeting between Malaysian delegation and the Executive of RCPI
(representatives from Medical Training and Examination Departments)
28th June 2013 Morning - Visit a training centre in Dublin

Golfers Itinerary

27th June 2013 Arrive Dublin Airport, meet & greet, transfer to hotel.
Free for own activity
Overnight - The Fitzwilliam Hotel
28th June 2013 Breakfast
1 Round of Golf at Portmarnock Golf Club
Overnight - The Fitzwilliam Hotel
29th June 2013 Breakfast
Depart Dublin and travel to Blarney and to Killarney with sightseeing
Overnight - The Killarney Plaza Hotel
30th June 2013 Breakfast
1 Round of Golf at Killarney Golf Club
Overnight - The Killarney Plaza Hotel
01st July 2013 Breakfast
Depart Killarney and head towards Adare
1 Round of Golf at Adare Manor
Overnight - The Dunraven Arms Hotel
02nd July 2013 Breakfast
This morning sightseeing to Cliffs of Moher - designated UNESCO Geo Park
Overnight - The Dunraven Arms Hotel
03rd July 2013 Breakfast
Free at leisure until transfer to Dublin Airport for departure home

Proposed Golf Courses

Non-Golfers Itinerary

27th June 2013 Arrive Dublin Airport, meet & greet, transfer to hotel.
Free for own activity
Overnight - The Fitzwilliam Hotel
28th June 2013 Breakfast
Sightseeing around Dublin City
Overnight - The Fitzwilliam Hotel
29th June 2013 Breakfast
Depart Dublin and travel to Blarney and to Killarney with sightseeing
Overnight - The Killarney Plaza Hotel
30th June 2013 Breakfast
Sightseeing around Killarney Area
Overnight - The Killarney Plaza Hotel
01st July 2013 Breakfast
Depart Killarney and head towards Adare
Sightseeing & Shopping – Limerick City Centre
Overnight - The Dunraven Arms Hotel
02nd July 2013 Breakfast
This morning sightseeing to Cliffs of Moher - designated UNESCO Geo Park
Overnight - The Dunraven Arms Hotel
03rd July 2013 Breakfast
Free at leisure until transfer to Dublin Airport for departure home

Cost Per Person in Euro (€) (Ground Arrangements Only)

Golfers 10 - 14 Persons Non-Golfers 10 - 14 Persons
Twin Share € 1,360.00* Twin Share € 950.00*
Single Room € 1,705.00* Single Room € 1,295.00*

Inclusions :-

  1. 6 Nights Hotel accommodations with daily hotel break fasts
  2. Golfers - 3 Rounds of Championship Golf & 2 days Sightseeing
  3. Non-Golfers 5 days of sightseeing
  4. Luxury Coach with Driver
  5. All local taxes
  6. Assistance of North & West Coast Links personnel for duration of itinerary

*Rates are subjected to change based on the number of participants and the airline you are using

Please reply before 30th MAY 2013

Sightseeing Sites

[ Back to top ]

10th Ministry of Health Malaysia-Academy of Medicine of Malaysia Scientific Meeting 2013
(Incorporating 16th Scientific Meeting of the National Institutes of Health and the National Ethics Seminar)
Theme: Performance Monitoring in Healthcare
29th September - 1st October 2013
Medical Academies of Malaysia, Kuala Lumpur


29th September 2013, Sunday
1400 - 1500 Opening Ceremony and Spech
Datuk Dr Noor Hisham Abdullah
(Director-General of Health, Malaysia)
1500 - 1530 AM Conferment Ceremony
1530 - 1630 12th Tunku Abdul Rahman Lecture
1630 - 1700 Tea
1700 - 1830 AM Annual General Meeting
30th September 2013, Monday
0830 - 0915 Plenary 1 | Ethics
The ethics of comparisons – Am I better
than the next doctor?
(Speaker to be confirmed)
0915 - 1030 Symposium 1 | Ethics
The ethics of performance monitoring –
The conundrum and the issues:
Public sector: Dato’ Dr Azman Abu Bakar
Private sector: Dato’ Dr Jacob Thomas
Accreditation bodies: Dato’ Dr Ravindran Jegasothy
1030 - 1100 Coffee/Tea
1100 - 1145 Plenary 2
Hospital Performance
1145 - 1300 Symposium 2
Hospital Performance
2. (To be confirmed)
3. (To be confirmed)
1300 - 1400 Lunch
1400 - 1445 Plenary 3
Individual Performance
(Speaker to be confirmed)
1445 - 1615

Symposium 3

  1. Individual Performance / Competency
    Performance Monitoring National Renal
    Report card
    Dr Lim Yam Ngo
  2. Eye care performance monitoring
    Dr Mohd Aziz Salowi
  3. Performance during housemanship
    Dr Sondi Sarakas
  4. Breast cancer treatment outcome
    Dr Lim T O
1615 - 1645 Coffee/Tea
1st October 2013, Tuesday
0830 - 0915 Plenary 4 (Ethics)
Whistle blowing through the ages – Is it
still relevant and needed?
(Speaker to be confirmed)
0915 - 1030

Symposium 4
Practice Patterns performance

  1. NHEWS primary care
    Dr Dr Hwong Wen Yea
  2. NMCS
    Ms Yvonne Lim Mei Fong
  3. Cardiology
    Dr Sharmini Selvarajah
  4. Ophthalmology practice – Changing trend
    Dr Goh P P
1030 - 1100 Coffee/Tea
1100 - 1300 Interactive Forum
Medical Schools’ Performance
Panelist: Deans of Medical Schools
1215 - 1300 Lunch

[ Back to top ]

2nd AMM-AMS-HKAM Tripartite Congress &
47th Singapore-Malaysia Congress of Medicine

23-24 August 2013
Grand Copthorne Waterfront

[ Back to top ]