Charting the path of future healthcare professionals

ASSOCIATE PROF DR PATRICK TAN Director, Clinical Skills Centre, AIMST University

IN the late 1900s, Malaysia embarked on promoting medical tourism particularly to Indonesia. The Malaysia Healthcare Travel Council was formed to coordinate and expand this economic activity.

Between 2011 and 2018, medical tourist arrivals increased from 643,000 to 1.2 million, yielding a revenue of Us$127mil in 2011 to over Us$362mil in 2018.

During this period, many new private hospitals emerged to provide world-class healthcare services at affordable prices. Many existing private hospitals also started to expand their operations to cater to medical tourists.

Before the Covid-19 pandemic, medical tourism comprised between 40% and 50% of the business in private healthcare facilities.

The local insurance industry also contributed to the business by providing personal and corporate health insurance, among others.

As the business of medical tourism grew, many specialists left public hospitals to join private hospitals for better remuneration. This created a vacuum in the public healthcare services, allowing new and younger specialists to fill the gap.

Due to budget constraints, however, there has been limited opportunity to train more specialists in the public healthcare sector.

It was reported in The Star’s education pull-out on August 2021 that Malaysia had only four specialists to 10,000 citizens as of June 2020.

In the meantime, we have between 5,000 and 6,000 fresh medical graduates annually who need houseman training, for which the waiting time to get a posting is between six and 13 months.

This situation may significantly affect the decision of potential students who wish to take up medical courses and ultimately the intake of students in all the private medical institutions in Malaysia.

Recently, the president of Indonesia announced the setting-up of an international hospital in Bali in collaboration with Mayo Clinic to reduce the flow of money out of the country due to medical tourism. This will certainly affect the medical tourism industry in Malaysia, which has yet to recover from the Covid-19 pandemic.

The opening of this new hospital will also have a domino effect on the healthcare industry in Malaysia. Job opportunities and the migration of doctors, especially specialists, from public to private hospitals would be reduced and so would the intake of new candidates for specialist training.

The challenges faced by contract doctors may get worse, and the intake for houseman training would further be delayed, resulting in jobless medical graduates having to take up other jobs in order to survive. The situation could also affect sign-ups for medical courses in private institutions.

How can private medical teaching institutions mitigate these changes? Those with financial resources can build teaching hospitals to cater for not only undergraduate but also postgraduate training, which is currently in demand.

Alternatively, these institutions will have to create competitive advantage by developing advanced clinical skills labs for both undergraduate and postgraduate training in collaboration with public and private hospitals.

Institutes with nursing schools could create post-basic nursing courses for specialised nursing. Venturing into other healthcare-related courses such as healthcare management and short certification courses would also create new sources of revenue.

Most importantly, they must create a resilient team of dedicated and talented workers to achieve sustainability. This is because human capital is the most important asset for any organisation.