News ...:: Berita Akademi, March 2005 ::... NATIONAL SPECIALIST REGISTER by Tan Sri Datu Dr Mohamad Taha b Arif, Director General of Health Malaysia The Ministry of Health Malaysia (MOH) and the Academy of Medicine of Malaysia (AMM) plan to have the National Specialist Register (NSR) up and running by the middle of 2005. The two bodies have collaborated for over two decades on this effort, through successive Director Generals of Health and Masters of the Academy. Numerous meetings and workshops at national level were held to discuss, debate and fine-tune the various aspects of a National Specialist Register. Various professional bodies have contributed in defining the criteria for training and competence in the respective specialties. Finally we are soon going to have only one National Specialist Register for the whole country. The AMM has its own Specialist Register, established in 1999 and, officially launched in November 2000 by YBhg Tan Sri Dr Abu Bakar Suleiman, then Master of the AMM and Director General of Health. The AMM Specialist Register is available in the website for inspection and reference. For years the MOH has its own gazettement exercise for specialists working in its hospitals and health facilities. This is a requirement under the General Order. Specialists have to be gazetted in order to be employed to the respective grades of service, and giyen appropriate remuneration. This process has worked well for the MOH. Under the Medical Act 1971, medical practitioners who practise in this country have to be registered with the Malaysian Medical Council. This register is for all medical practitioners, whether Specialists or non-specialists. There is no provision for a specialist register under the present Act. However, in the proposed revision of the Act, there is a provision to register specialists as well. Purpose of the National Specialist Register The NSR will ensure that doctors designated as specialists are appropriately trained and fully competent to practise the expected higher level of care in the chosen specialty. With the NSR in place, doctors will be able to identify fellow specialists in the relevant specialties to whom they can refer to either for a second opinion or for further management. Importantly the NSR protects the public, and will help them to identify the relevant specialist doctors to whom they may wish to be referred to or may wish to consult. The NSR is in fact an exercise in self-regulation by the medical profession, having the interest and safety of the public at heart. Through the NSR, the medical profession will strive to maintain and safeguard the highest standards of specialist practice in the country. With the impending implementation of National Health Financing Scheme, payment for service will be based on the qualifications and skills of the practitioners. Hence, the establishment of a NSR will be essential as a reference resource. Under the umbrella of the World Trade Organization, Malaysia will be opening its door to foreign medical practitioners in compliance with the General Agreement on Trade in Services (GATS). It is essential to have the NSR in place to ensure that only appropriately qualified and competent foreign doctors are permitted to practise their respective specialties in this country. This will safeguard the interest of the people, and ensure that standards of specialist practice are not compromised. The Process It has been agreed that the present NSR will incorporate the present AMM Specialist Register will automatically be categorized as specialist in the National Specialist Register. Specialist who are not in the AMM Specialist Register will have to apply to the Secretariat of the National Specialist Register, housed in the AMM. The applications will be forwarded to the respective Specialty Boards. The President of the Malaysian Medical Council, who is also the Director-General of Health and Chairman of the National Credentialing Committee, appoints members to the various Specialty Boards. Every Specialty Board has representatives from the Ministry of Health, the AMM and the respective specialist society. The Board will review and approve the application if there are documented proof of qualification and training according to agreed criteria. The Board will then recommend that the applicants be credentialed as specialists. A fee will be charged to the specialist who applies to be registered with the National Specialist Register. This fee will go towards paying for the expenses incurred by the Specialty Boards, maintenance of the Registry, as well as administrative costs. Other than the initial funding from the Ministry of Health to establish the Permanent Secretariat, the National Specialist Registry will be self-sustaining. The specialist register is time-based and renewable upon proof of continuing professional development and continuing medical education activities by individual specialists. The duration has not been decided, but will probably be between 3 to 5 years, based on practices in other countries. The NSR will draw from the experience of the gazettement exercise of the Ministry of Health when the former is up and running. With the NSR in place, we are looking forward to having just a single specialist register for medical specialists in all sectors, including the Ministry of Health, the universities, as well as the private sector. The credentialing process will of course continue to evolve to suit the evolving needs of the people and the country. All constructive suggestions and comments from fellow medical practitioners are most welcome. Let me urge and appeal to the whole medical profession to fully support the National Specialist Register. back to news