MRCPSYCH, The Road Less Traveled

A few days ago, a couple of medical graduates who are currently waiting for their housemanship posting had asked me to brief them about the MRCPSYCH program and how it compares with the Master program.

In my conversation with them, I addressed a lot of issues regarding the specialty training in Malaysia and the issues surrounding our training. The stigma, the challenges, the difficulties, the hard work.

This post is inspired by my interaction with them.

***

The thing is, my behaviour has always been consistent. I have always spoken up about the same kind of issue, over and over again. 

I don’t agree for anyone to persecute a whole group just because they are ignorant or biased in their views. I don’t agree for anyone to persecute a whole group out of a mistake done by a few people in that group. I don’t agree for anyone to badmouth a whole group for incompetencies committed by some in that group. Because racism and Assobiyah is a sin in my religion!

If we are Muslims, we surely can relate. When Bali bombing happened in 2005, many Muslims in Australia felt the heat. Islamophobia and hate-related crimes increased. It was not surprising to encounter some rednecks shouting at us “Go back to your country, you turban-head!”

My experience in Australia shaped me so much, to the point that I have perfected a very sharp vision of how not to overgeneralize a whole group for some idiotic things committed by some of the people in that group.

***

When I was a HO, I felt so angry when I heard some of the consultants in the hospital talked badly about Russian grads or Indonesian grads or Ukraine grads. I was an Australian grad, and therefore I was spared the stigma. But even then, it was said “Overseas grad are not as good as local grads. They are not good at setting brannulas. They are not exposed to procedures as much!” Pffft! But one month into your first posting, ANY HO can set the brannula regardless of where they grad! One month into medical posting, ANYONE can do procedures for Peritoneal Dialysis and short lines and long lines. So, what exactly is the big deal here?

So when I was a junior MO, I wrote a long blog post defending the Russian grad. (It can be read H.E.R.E.) I wrote that, contrary to people’s belief about the Russian grads (that Russian grads had achieved bad SPM results and should not have been qualified to go to a medical school) those who were government-sponsored to Russia were actually the cream of the cream in our SPM batch. They went to Russia based on their trial results! It was the government policy AT THAT TIME, to send brilliant people to Russia. I went to Australia based on my SPM result… not my trial! So these government-sponsored Russian grads were actually excellent students.

A lot of the Russian grads (some of them my friends) had widely shared the post. It became viral in no time. I was quite surprised.

And now, we have had many specialists and even consultants in various fields who were Russian grads. In fact, there are still many MOs who are currently doing their master training who are Russian graduates and they are just as good as the local grads or the UK/Ireland/Australia/NZ grads.

See? All your skepticism and your ‘budget bagus’ statement and yes, your arrogance!! have been proven wrong! Any incompetency, attitude problem or lack-of-knowledge in a Russian grad, they are personal to that particular person! You are not being fair when you overgeneralize the whole group! Yes, you had PERSECUTED the whole group just because they were weak and disadvantaged

When there were so MUCH brouhaha about how HOs in the shift system would never be as good as us who were doing our housemanship in the on-call system, I had been very consistent in defending the HOs in the shift system! Even though I was a HO during the on-call system, I NEVER act like I have a crystal ball to see the future and automatically KNOW that none of them will be just as good as me.  I defended the shift system many times! Because I don’t,  and NEVER WILL condone anyone to persecute a whole group or a whole system for any mistake or attitude issues done by some people in that group or in that system! How can you be so small-minded and so certain that the whole group in that system will never be a good doctor just because they have a different training than you! I have many friends doing internship in Australia, UK, New Zealand and Ireland… all of them are good doctors now even though the shift system is implemented there. In fact, the irony is, we send our undergrads to learn to become a doctor in those countries who have been doing the shift system for decades! And then we have the cheek to bash the shift system?!

In my department now, we already have MOs who did their housemanship when the shift system was already implemented. And they are just as great a doctor like the rest of us seniors! In fact, banyak lagi senior yang baloq liat compared to them! Again, all your ‘budget bagus’ statement that this shift-system will produce bad MOs have been proven wrong! Any bad MOs prevalent in the environment stems from their own personal issue and again, it is ridiculous to persecute a whole group based on mistakes done by some in that group!

***

External Pathway Vs Master Pathway

There have even been a lot of ‘budget hebat, aku paling terer’ statement when it comes to bragging about systems in specialty training.

Nowadays, there are already many specialists and consultants who were the product of MRCP, and thus they received less criticism than us MRCPSYCH. But still, you can hear people saying things like “MRCP is not as good as master”.

But the reality is, there are NOW many consultants who are the products of MRCP, some of them are cardiologist, respiratory physician and gastroenterologist ALL OVER THE WORLD. When you say they are not as good as the physicians in the Master pathway, what exactly do you mean? On what basis do you say that? Is the Master qualification recognized all over the world outside Malaysia like MRCP? No! Do you have an objective scale in which to measure how better the Master pathway is compared to the MRCP? No! Or are you just giving an emotional statement just because you disagree with the MRCP physician’s management? Or maybe you have had an inter-departmental issue or disagreement that would have existed anyway regardless of whether the physician is an MRCP product or a Master product?

This is what is happening with MRCPSYCH too. Unlike MRCP, we are only just recognized in Malaysia around 2013/2014. So everyone is having an adjustment disorder about the whole thing. And of course the most logical thing to do – in their opinion – is to bash the MRCPSYCH system and comparing them with the master system in an unfavourable manner, despite the fact that the MRCPSYCH system is recognized the whole world over!

Now, my question is, how sure are you that MRCPSYCH system which is world-recognized will never produce good psychiatrist like the master system? Do you perhaps use a better and different book than us? Do you use special Malaysian-made books that cater specifically to Malaysians psychiatric diseases? (Or do you, in fact, use UK-based books and some of our MRCPSYCH notes too, hmm?) Do you perhaps have a larger amount of greater professors and lecturers compared to the rest of the world? Do you read different journals than us? Or do the people doing the master pathway are somehow less forgetful, more diligent, more up-to-date in anything compared to the MRCPSYCH students? I mean, WHAT?

Oh yeah… maybe the master students were more ehem, GUIDED by lecturers compared to us who were so-called ‘study sendiri-sendiri.’ But then I have checked with several master students too… not just in psychiatry but also in other fields…. they were always told “La ni kita adult learning ya. Bukan semua kena spoon feed. Kena belajar sendiri and tahu apa nak belajar.”

Hahah. So what is the difference, then? Kau belajar sendiri, aku pun belajar sendiri! And nowadays, how many percentage of your time are spent at the uni, especially if you are an out-campus student and also doing various rotations all over KKM facilities? The same KKM facilities that we the MRCPSYCH students use!

Oh yeah… master students have to do thesis! MRCPSYCH tak payah.

So what? I am not going to be a researcher. I am going to be a clinician! You choose master, you deal with YOUR requirement. I choose MRCPSYCH, I deal with MY requirement and the requirement set up by KKM. I pay using my own money to train in MRCPSYCH pathway. If you want MY requirement to be the same as YOURS, then maybe the amount of financial support by the government to MRCPSYCH candidates should be the same too. Everything should be the same then! Tak payah nak buat two different pathways if you guys are so KIASU to question why MRCPSYCH candidates don’t have to do any thesis. My question is, why didn’t you choose MRCPSYCH if you had cared so much regarding how we don’t have to do any thesis? Does doing the Master thesis help you being a better clinician? How much difference does it make? I want to know. And if you think doing this thesis makes you into a MUCH BETTER clinician than the MRCPSYCH candidates, then you shouldn’t feel so bad that you get to do it. Shouldn’t you want what is best for your adult learning despite what other people are doing in another pathway? 

One last point about doing thesis! It would be UNFAIR and VERY UNJUST for anyone to suggest that the MRCPSYCH candidates should do a thesis, just like the Master candidates. When you are doing a master program…. OF COURSE you have to do a thesis! All master students in OTHER FIELDS also have to do a thesis to be eligible to get a MASTER DEGREE! That’s why nama benda ni MASTER PROGRAM! Whereas, MRCPSYCH is a MEMBERSHIP program! We don’t get a MASTER degree despite the fact that our syllabus are the same with the master program. If we ever want to pursue a PhD in the future, we have to get a master degree first before we can do a Phd! But for you guys who are already doing the MASTER Degree, if ever one day you want to do a PhD, you can straight away do it because you already have a Master Degree! Get it? Faham tak beza Master dengan membership program? Semua Master degree kena buat thesis, regardless of their fields… faham tak? How is that FAIR and JUST for you to suggest for us to do a thesis when we are PAYING OUR OWN WAY for an exclusive world-recognized membership program and NOT for a master degree? Semua nak sama rata… tiba-tiba at the end of the day, korang dapat master degree tapi kami pula dapat membership of Royal College of Psychiatrist? Nak sama rata celah mana?? (Gosh, aku  tak faham how some people utilize their minds! So weird how they want everything to be fair … as long as in the end, it STILL favours them!)

So, if you are a smart person who JUST KNEW DEEP IN YOUR HEART that you don’t want to do a PhD in the future and you don’t want to become a lecturer or a researcher and you just want to be a CLINICIAN, you would have chosen the MRCPSYCH program! Simple decision making, isn’t it? Tapi kalau kau nak jadi CLINICIAN tapi nak juga ambil Master Degree, that’s YOUR choice! Mungkin kau rasa Master Degree lebih hebat, lebih seronok, lebih banyak pengalaman…. for whatever reason… that is YOUR choice! Jangan nak suruh kami pun nak kena buat thesis! Siapa suruh kau pilih Master?? Lepas tu nak jealous dengan kami pula? Kemudian at the end of the day kita sama-sama buat thesis, tapi kau dapat Master Degree, kami dapat Membership! Banyak cantik! Fair sangat lah tu? How biased is that!

In many parts of the world, most doctors only do a Membership program rather than a Master program because as a doctor and a clinician, that is already ENOUGH. Malaysia should have its own Membership Program for post-graduate training without having to go through the Master system. Maybe this is something we should start looking into! UK has it (RCPsych UK), Ireland has it (RCPsych Ireland). In Australia and New Zealand, they have a regional membership program called The Royal College Of Australia and New Zealand and their candidates also don’t have to do any thesis! Semua orang yang buat membership program, memang tak payah buat thesis! Faham tak? Please get this into your head.

If we have our own local membership program, only then it is fair for you to do some comparison between MRCPSYCH and the local membership program. Candidates can even decide to do BOTH the local membership program as well as the MRCPSYCH program just to get an extra international recognition. (Maybe we can set up a Royal College of Psychiatrist of Malaysia? Or maybe we can collaborate with regional countries and make it into an ASEAN College of Psychiatrist or something. Tak payah dah KKM nak bayar duit kepada universiti untuk train specialists! Besides, most of  the KKM facilities are being used for master training, anyway kan?) Let’s just keep the master program for those who want to become trainee lecturers. Of course trainee lecturers have to do a Master program (and therefore a thesis) if they want to become a lecturer or a researcher or an academician.

Look, at the end of the day, all of us have a choice! We choose according to our own views about what is beneficial for us and how it would fit our commitment and lifestyle. You had a choice too. Once you have made your choice, you really should stop questioning regarding how greener the other side is.

And before I forget, please remember that people who live in a glass house shouldn’t be too quick to cast stones.  The Master system is also very vulnerable to criticism. At least, I TRUST the integrity of the MRCPSYCH pathway. I mean, we NEVER heard any incidence of someone getting hold of leaked questions. We NEVER heard other candidates complaining about how they were disadvantaged because  they did not know about the leaked questions until after the exam… because that kind of thing just does not happen. There is a reason why MRCPSYCH is world-recognized. Because we adhere to a very strict exam guidelines standard and  procedures. Can we say the same about the Master system? Think about it before you say anything disparaging about another system. There are good and weak points in BOTH systems. You are welcome to point out the weakness in my system, but you too must be ready to hear your weakness being pointed out in return. Fair, ok?

***

Now, let me be very clear why I chose MRCPSYCH over Master.

It does not have much to do with the fact that MRCPSYCH is recognized all over the world, even though that is a really good aspect of doing MRCPSYCH! I don’t think that having a world-standard recognition automatically makes MRCPSYCH better than the master system (yup, unlike some people, I don’t feel the need to belittle other system. I think belittling others is a sign of insecurity! But if you belittle mine FIRST, I will certainly retaliate. So jangan nak jolok sarang tebuan unless you are prepared to be stung. Because I will sting you!) Like I said, we use the same books, the same syllabus, the same DSM-5 and the same ICD-10. MRCPSYCH is not better than the master system or vice versa. Please be CLEAR on this!

The reason I chose MRCPSYCH is because I am already used to the freedom and the ‘adult learning’ in the western system! I am free to explore knowledge and form my own opinion without having to navigate politics in the uni. I don’t like those things! I am very outspoken too. I don’t think I can tolerate the Malaysian mentality that outspoken-ness is equal to arrogance (Not all Malaysians are like this, and not all workplace have mentality like this. Even my workplace is generally nice and supportive. I need to put this disclaimer so that no one ends up with their feelings unnecessarily hurt).

I avoid any type of environment that would try to regulate or institutionalize my thinking and my ability to speak up about anything that is wrong or unjust. That is THE ONLY REAL reason I chose MRCPSYCH over Master.

I have heard some disturbing stories about the master system (not necessarily in psychiatry but in other fields as well. I don’t think this is the norm in the master system… but it can and does happen). My friend had told me regarding one student who was quite outspoken regarding her dissatisfaction in the master system, and because of that, she was barred from taking an exam. I asked my friend “Perhaps, she has an attitude problem? Was she always late or did not perform her responsibility well? Was she MIA? Maybe she didn’t finish her assignment?”

My friend said, “No, she was just more vocal about what she found wrong about the master system. So she made a few enemies. She had no knowledge issues. When she takes her exam in the next sem, she passed with just one attempt… she is quite intelligent actually.”

I was bewildered by that story. How can you bar someone from taking an exam just because she speaks up against the system? How dare you! I told my friend “Kalau aku kat tempat kawan kau, I will sue the uni! And I will send complaint letters to many people in KKM! See me in court!”

My friend laughed, “Lagi teruk dia kena nanti. Kami semua ‘yes boss’ ja la,”

There was also another story regarding how ‘adult’ the learning really is. You just did everything and you had to pay for it too. “Kami yang organize kursus. Kami yang dok organize lecturer mana nak bagi talk. Kami yang kena jadi MC, kami yang kena jadi usher… tapi kami pun kena bayar RM500 untuk kursus tu, Padahal kami yang organize. Ramai orang tak puas hati… tapi senyap jalah.”

Wow… how, ehem, unique is that arrangement? In the Western country, the trainees would have raised hell if they are treated that way! Instead of barring the students from having exams, they would be scrambling around doing damage control to their reputation. When you pay for something, you are the service-user or the participant of that course! Somebody else should be organizing it! Not you… who had PAID for it! There is an emphasis for getting the value of your money when you are doing any transaction in the Western country! That is just a simple concept of fair dealing!

***

screenshot 2019-01-17 12.25.49
My Facebook Status on October 12, the day when  Dato’ Azman came to HSB for a session with MOs.

Another issue in the Master system is regarding what happens if you want to quit your master program. I had raised this issue myself when Dato Azman came to HSB even though this has nothing to do with me and more relevant to the master students (So jangan ingat aku asyik tulis saja. Bila ada peluang nak cakap dengan orang atasan, I do it, okay! I just need to feel annoyed enough and then I can REALLY speak.) And Dato Azman was quite nice in listening to all the issues I had raised. I applaud his patience in giving us, the MOs, a fair and transparent platform to speak up.

Another friend of mine who was doing a master program in another field had told me that if she wants to quit her master program, she has to pay RM250,000 to the government.  I was aghast!

“Takkan sampai RM 250,000 kau spend untuk belajar kat uni for these few years?!”

My friend told me, “Dia cakap sebab kita ambil tempat orang lain. So dia nak penalize kita dengan RM250,000 tu. Padahal satu semester RM 8000 saja. Kalau lapan semester baru 64,000.”

I shook my head in disbelief. RM64,000 vs RM 250,000. That is almost QUADRUPLE the amount that you actually used to do your master. How can they justify penalising people QUADRUPLE the actual amount of money used? In my head, I went “This is even worse than usury! Riba kot! Even worse than hutang dengan Along! Just because the master pathway had the MONOPOLY in the business of specialty training, it doesn’t make it right for them to impose unjust deals and rules!” (That is why monopoly is bad in any sector. It encourages unethical abuse of power and the consumers have no rooms for negotiations of their rights because they have NO OTHER ALTERNATIVE!)

So on the day of the meeting with Dato’ Azman, I went down to where the mic was and I said, “Many people are interested in  the master program. But you made it so unattractive to us with oppressive deals. When I am doing MRCPSYCH, I know what I would be getting for everything that I have paid. When I pay RM1300, I get the course notes. If I want to join online classes/tutorials, I can pay for it and I get classes/ tutorials. When I want to do mock exams, I pay for it and I get to do mock exams. When I want to do my actual exam, I pay for it and I get my exam. If I fail the exam, I just need to fork out MORE MONEY to pay for another attempt and I will get another attempt. There is no ‘penalty’ whatsoever. The system is so much more transparent, money-wise. I get what I pay for and I KNOW what I am paying for! No one feel cheated or short-changed! So…how can we justify QUADRUPLING the amount of the actual money used just for the sake of penalty?”

Seriously, I was quite outspoken in that meeting. I mean, think about it! Why don’t you penalize the person by asking her to pay another RM64,000 on top of what the person already owed the government? Which means, get the person to pay RM128,000 (RM 64,000 for her own study + RM 64,000 Penalty for the place of others that she had taken = RM 128,000)  That is more reasonable, isn’t it? (but still unfair. In contrast with the MRCPSYCH system, you only pay for what you want or for what you use. It is fair and transparent!)

We call ourselves as Muslims and Malaysia is a so-called Muslim country! And yet in ANY ‘urusan Muammalat’, the Western non-muslims are more fair and more just and more transparent in all their dealings and transactions! That is the truth! And that’s why when I see intelligent, fair-minded Muslims, my heart softens towards them because they remind me of Australia, the place where I had learned to become more mild-mannered after I was impressed by their intellect and their patience and their fair dealings. In their system, they are MUCH MORE Islamic than us! (Bila balik Malaysia, my disposition has suffered a relapse. Hahah. Hopefully, with the new PH government, the environment in our institutions will change accordingly and my manner will become mild again. LOL)

I told Dato Azman, “I am actually doing the external pathway… but I am just speaking up on behalf of my master student friends scattered all across the fields. What is the RM250,000 money for? They learned mostly by themselves just like us in the external pathway… what is the money paid for then?”

Dato Azman raised his eyebrows “They learned by themselves?” He sounded surprised. And Thank God, there were a few MOs (I didn’t know which of them in the audience) had shouted yes! (Hahha. Thanks guys, whoever you guys are, for the support! I needed it at that time! You guys rock!)

I went on to say, “When we were doing our undergrad study, RM250,000 might be a somewhat justified amount for us to pay back. We got a lot of lectures every week, we got tutorials, we got quizzes every month! We could roughly see where the huge amount of money was spent! But with ‘adult learning’, I do not understand what is the RM250,000 penalty for.”

Dato’ Azman had noted what I had said and he said he would think about it and look into it. I hope, he really does. He also gave his email address and he said we are welcome to write to him directly for any issue. He was quite nice actually despite having to hear a lot of issues and complaints by many MOs that afternoon. Some MRCP candidates had also spoken up and supported what I said regarding our issues in the external pathway. MRCP candidates and the MRCPSYCH candidates kind of conquered the mic that afternoon. Hahaha.  But Kudos to Dato’ Azman for remaining calm. (Actually there were so many other issues I had gone to the mic for but not all of them are relevant to this post. Aku antara orang yang paling kerap guna microphone on that day. And seriously, Dato’ Azman was very patient in handling my questions. Tabik spring!).

I think, this is what leadership is about. Listen and respond.

The era of autocracy is outdated and should have been long gone! Dialogue is in! When someone criticizes your system, you don’t bar them from exams! Instead, you engage them in an intellectual discourse and settle your differences. You remain objective and fair towards them. Be matured! We are all adults here! But once you use autocracy in a cruel and unjust manner, you will one day encounter a student who may fight you back and will never stop fighting until she/he wins against the system! The probability is such that when you use the same method over and over again ENOUGH TIMES, one day you will encounter an EXCEPTION to the norm. When that time comes, you would wish you have never used autocracy against the student and had used intellectual discourse instead. Because trust me, some students may have the courage to fight you all the way to the court. Just imagine the kind of damage it would do to the reputation of the system. It is already happening in housemanship  and now our housemanship training has gotten a terrrible name already. So, please use the method of engagement rather than autocracy in anything you do. Because in this generation, the current maxim is “Be fair or Beware”.

***

Some people had also said “Bila ada external pathway ni, kita tak boleh nak control who are the candidates that become our future psychiatrists. Who knows…orang tu ada attitude problem ke… mungkin diorang tak sesuai nak jadi psychiatrist. Kalau dalam master program, kita boleh stop dia jadi psychiatrist from the very beginning kalau kita rasa dia  tak sesuai.”

Wow…. this is SO Malaysian! Do you think NONE of the master graduates had ever had any attitude problem? I can name a few, too! But do I go around saying “See? What kind of bad psychiatrists the master program is producing? And look at the products of master program in other specialties! Some of them molested HOs. Wow… such a splendid ‘attitude screening system’ you have in the master program, huh?And with those who didn’t molest HOs, they simply remained silent out of sheer selfishness and cowardice! What kind of specialists are the master program producing!? Look at how institutionalized their thinking is that they would ignore any wrongdoing just because it comes from someone of a higher hierarchy than them… perhaps because they are so used to it in the master system. Asyik senyum and cakap, ‘yes boss’ or ‘yes, prof” all the time!” Did I say any of that? Ada ke aku keluarkan kata-kata overgeneralization macam tu? Ada aku generalize semua master products as cowards based on that notorious incident? Tak, kan?! Because I am fair in my thinking and my judgment! I don’t over generalize people. In psychiatry, over-generalization is a cognitive distortion, ok? 

Should there be any issues with the attitude of your future specialists, you deal with them when they come along! Just like in anything in the world, you intervene when there are issues! You shouldn’t PRE-EMPTIVELY discriminate the whole group with your snide remarks based on your bigoted, discriminatory unfounded fears! But now, what  we did was the EXACT OPPOSITE! (klasik perangai orang Malaysia! Suka buat benda tak logik!) When there are serious issues with your specialists, you remain quiet and silent because you “nak jaga nama jabatan!”. Bila specialist dah ada isu, kita pula pi buat senyap! Sampai HO pun boleh kena molest for MANY YEARS! (Tapi ada hati nak condemn the external pathway sebab kita tak boleh nak, ehem, ‘pre-emptively screen their attitude’! Wow! Amazing reasoning! Boleh tak kalau ada isu, deal with it then and there?! It is a more logical approach, isn’t it? Tak payah nak kalut risau pasal the future, sedangkan benda yang kita boleh intervene STAT, kita tergamak buat senyap for MANY YEARS! What is that?! How dodgy is our priority!)

If an MRCPSYCH candidate does not perform well in the department, you can talk directly to the candidate and tell the person to improve. The candidate’s particular issues should not be generalized to the whole system! If a specialist asks an MRCPSYCH candiate something that she/he doesn’t know… maybe it is the candidate’s personal lack-of-knowledge and incompetency issues. It doesn’t mean the whole MRCPSYCH candidates are not good. Likewise, I have seen quite a few Master candidates who are not that good… some of them are already a specialist and they can still be confused about certain aspects of patient management. To me, that is just human! I do not generalize that to the whole Master program, do I? We read, we take exams, and then we have a tendency to forget a large chunk of it! That’s why we have CMEs! So that we can refresh our knowledge, get it?

So, when you come up with a statement, please be fair! You might get away with it when your audience are not as out-spoken as me or if they always feel the need to kowtow to people and please the authority. But I am not like that. That is just my personality.

personality

I reiterate that I am not bashing the master system. I  think they produce very good psychiatrists, in general. But my personality, my principle against unjust contract, my aversion to oppression, and my personal inclination, had made me choose the external pathway, instead! It is MY personal choice. And you can openly judge me for it… don’t worry, I will just argue against your points. If you can openly judge my choice, I can openly judge your choice too! It will be fun! But if I speak and answer you back in a way that might hurt your feelings, don’t think I am arrogant. You had it coming. And I am the sort of person who fight ALL THE WAY once I am angry enough!

I have always spoken up against the persecution of any underdog. My behaviour is CONSISTENT. If MRCPSYCH is considered the underdog program, heck, I don’t mind speaking up about it. I have spoken up (written up) for others before… and so, believe me, I have no problems speaking up or writing up for myself.

I will continue to do it until MRCPSYCH is as established as MRCP and any issue will then become redundant background noise! 

***

“Don’t worry, Afiza. Kalau depa dok buat payah, kita pi ja la kat Singapore ke Brunei ke…UK pun boleh. Terus jadi orang sana. Gaji pun lagi banyak. System pun lagi bagus.” Said my friend.

That is true. But it will be sad for Malaysia isn’t it? I understand now how the ‘brain drain’ phenomena befalls Malaysia. People get upset by some bureaucratic red tape and they just pack up and leave! And Thank God, that option is always available for MRCPSYCH candidate

Yup…. with MRCPSYCH, I retain my freedom. Free to speak up. Free to move out. Free to address my concerns and the concerns of my colleagues. I will not exchange that freedom for anything in the world. And if people ask me why I choose MRCPSYCH, this is why!

If you have different values than me, you do you! Live and let live! But if you try to belittle my pathway in front of me just because we have different priorities in life and different lifestyles, get ready for my rebuttals. Because I will give them! This is my promise!

Disclaimer:

This is my personal blog and my personal opinion on Malaysian specialty training. It does not reflect the opinion of anyone in KKM or in my department. Please also refer to my blog disclaimer on the bottom right side of the page. My blog has been around since 2009 and it has always been dedicated to me recording about my life as a medical student then, and my life as a doctor now. I have always been very outspoken about things even when I was a houseman. My blog is a place for sharing of life experiences, life-philosophy, world-view and opinions as well as for advocacy of the causes I believe in. So, if you disagree with me, I encourage you to have your own blog and advocate for your own point of view. I also encourage you to leave a comment if you disagree with me and we can debate the matter. This is a free country that respects the rule-of-law since Pakatan Harapan won the General Election last year. Which means, everyone can have their own point of view and advocate for what they believe in. Any assumption, presumption, speculation or hurt feelings that result from what I had written are the responsibility of the readers themselves and they are accountable for it in its entirety. 

15 thoughts on “MRCPSYCH, The Road Less Traveled

  1. Alvin

    Dear Sir, I enjoyed reading your blog especially regarding the current issue of Malaysia health care system. I am second poster Houseman and interested to further my career in psy, would you mind to explain more on how a houseman to take mrcpsych. Thank you

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    1. Hi Alvin.
      I think you have my gender confused. Why do you call me sir? LOL.

      Anyway, I am glad to hear that you are interested in psychiatry. But I am pretty sure that in order to be eligible for Part A of MRCPsych, you must have full registration MMC number. And therefore, you cannot do it i while you are still a HO, I think. Some do go ahead and do Part A MRCPsych using there provisional MMC number during their last posting as a HO.

      If you are inclined to do it, then I guess you can visit the website of The Royal College of Psychiatrist and click the section on exams. There is a simple step-by-step instruction on how to apply for Part A in their website. You can also subscribe to online bank questions and course notes from MRCPsych Mentor and SPMM. Best of luck!

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  2. Zhong En

    May i know which one is the better option to subscribe according to your experience? MRCPsych Mentor or SPMM? SPMM is kinda pricey though XD

    Thanks

    Like

    1. I subscribed to BOTH Mentor and SPMM. Mentor provides you with basic and easy-to-grasp concept that would serve as a good foundation for you to build your knowledge on. SPMM can be a bit overwhelming if you don’t even have any basic knowledge to begin with.

      So what I did was, I subscribed to Mentor first and did all the questions. And then I subscribed to SPMM. Their questions and their notes are VERY HELPFUL. Don’t bother subscribing to Birmingham… I don’t think Birmingham is that good. Alhamdulillah, I passed both Part A and Part B at one attempt… ONLY using Mentor and SPMM. So to me, that should be enough.

      All the best!

      Like

      1. Anonymous

        Thanks a lot for your detailed reply! It’s really helpful in helping me prepare for the exam. I have another question, is it possible to attempt Part A during housemanship by using the half registration number? Do you know anyone who done it before?

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  3. Zhong En

    Thanks for the detailed reply Dr. Afiza! I have another question, is it possible to attempt Part A during housemanship by using the half registration number? Do you know anyone who has done it before?

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    1. I do not know anyone who has passed Part A during housemanship. And even if anyone is lucky enough to pass Part A during housemanship, his qualification would not be recognized by KKM. KKM explicitly said that candidates must have their full MMC registration while sitting for 1st paper and failure to follow this condition will render their qualifications to not be recognized by KKM.

      So there really isn’t any benefit for you to attempt Part A while you are still doing housemanship. My advice is for you to focus on getting through housemanship first because there are a lot of important medical knowledge from other specialties that you are going to have to learn to be a holistic psychiatric doctor. All the best!

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        1. MO will choose which department they want (subject to availability of course. Sometimes otehr departments may lack MOs, so you will have to go other departments first before you can get to your real department of interest. It is all luck as well).

          Once they are in the department, they might have to rotate as well within the subspecialties in the department. For example in psychiatry, there are MOs who will be in charge of Addiction psychiatry, child psychiatry, liaison psychiatry, community psychiatry, just to name a few. You don’t stop doing rotations until you are done with all your medical training.

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          1. Ev

            i see….
            im interested in Psychiatry so im trying to plan on how to get into the department when i become mo, some of my friends planning to do their mrcs etc part A during housemanship so that they can secure their place in their department of interest (thats what they said) but like u mentioned, it wont be recognised by KKM as they still dont have full MMC registeration, from your experience, is there any tips that u can share for those who want to join their department of interest, in ur case Psychiatry when they become MO? 🙂

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          2. Sorry… I have got no tips on how to secure a place in psychiatry. In a lot of hospitals, there is a waiting list on which MO will next enter any particular department. You must apply and wait your turn.

            Of course having Paper A might help expediate the process… might enable you to jump the queue. (It MIGHT. But there is no guarantee). Perhaps, you can RE-TAKE your Part A once you are already an MO…otherwise, it won’t be recognised by KKM. Maybe one strategy is to do Part A as a HO to enable you to get into Psychiatry Dept… and then RE-DO Part A as an MO later. But I do not recommend this course of action. I have never met anyone who had passed their Part A without some experience in Psych.
            But there is no need to rush things. Our Psych patients have a lot of underlying medical illness too. Whatever department you are posted to before you can get into psych dept will be beneficial for you. I was in ED before I got into Psychiatry and the experience I got from ED posting and other housemanship postings were really helpful.

            All the best, ok!

            Like

  4. Shivvvaa

    Hi Dr, I’m here to ask something about MRCP. I know it is very unrelated to what you have talked about, but I was wondering if you could provide me some basic info on MRCP. You have said that KKM won’t recognize people who passed mrcpsych part A taken with temporary registration number, does it apply the same to MRCP? Because I have read several blogs mentioning that we can sit for MRCP 12 months upon getting degree, regardless of still waiting for houseman posting or working as HO. If we sit for all the parts for MRCP before even beginning MOship, are we still accepted for gazettement in IM, will our results still be recognized by KKM and Hospitals ? I hope you could kindly light me up with some answers as I have asked many doctors in their blogs, but I don’t get replies 😦 . I also wish you all the best for completing your mrcpsych 🙂

    Like

    1. Hi there Shivvvaa

      I am sorry that I cannot give you any detailed answer about MRCP because I don’t know. But I expect, the requirement will be the same because passing the theory can never be enough without experience as medical MOs. Experience is a better teacher than any theories you learn in the isolation of your own room.
      But the best people to ask will be the medical MOs who are undergoing the MRCP training. They should know.
      All the best for you future undertaking. Keep the passion burning and you should be fine.

      Like

  5. Ain

    hello Dr, i love reading ur blog, i gain lots of knowledge from reading ur blog so thank u 🙂
    i have a question regarding to the Master system, is it being recognized only in Malaysia or also in some other countries? meaning u can only practice as a specialist only in Malaysia, if u go for master pathway?

    Like

    1. Hi there Ain,
      I am glad to know that you enjoy reading my blog. Thank you for visiting this humble abode of mine.😁
      Unfortunately as far as I know, the master pathway is only recognized in Malaysia.
      If being recognized in many countries is important to you, then you can always do MRCPsych. But if you are not planning to practice anywhere else and you are going to stay in Malaysia anyway, then it really doesnt matter whichever pathway you choose. It depends on your personality and your preference, really.

      All the best!

      Like

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