Welcome to the discussion.

I agree 10K a day for non-procedural Doctor would be nearly impossible due to limitations of time. But some do minor procedures in their clinic or have their own ultrasound machines or blood analysers etc . So occasionally they may hit that number.

Thats why we previously mentioned procedural and non-procedural doctors. For good busy procedural physicians, 10K a day is entirely possible... although maybe not every single day. Most do do saturdays as well if there is demand.

I admire your altruistic view of doctors and the world.

There's too much to debate here, so I'm going to pick and choose things that stand out as need a response.

The US physician average is an AVERAGE. That means there many above that. Thats also including GPs by the way. Their average is likely the average of our top 10%

Tier 1 hospitals like Gleneagles, PCMC, SJMC have a policy that they will not send patients away just because they are high risk or ill unless the patient or family requests it. They have a broad range of expertise and therefore can handle nearly all cases. Only the smaller ones will becuse they lack the experts in certain fields. Gleneagles currently even has an Infectious Diseases specialist covering from Sg buloh to help deal with things like this nCoV 2019 risk management.

You seem to think the reason successful private doctors earn alot by overcharging. Like I said , the truth is that they charge according to the set fee schedule. All of them charge the same amount. The only way to make more is to see more and offer more services. If you just want to sit in your clinic and see 10 patients a day, don't do on-call for emergencies and not take the risk of surgery or sick inpatients.. then you're not going to even pass 20K.

But lets say..  you are a good procedure based doctor like a gastroenterologist who sees 15 patients (this is not even that many) a day in clinic, accepts emergency cases and referrals no matter how ill .. usually have between 6-8 inpatients ... Do 2 or 3 colonoscopies a day maybe including removing a tumour/polyp. or stopping a bleeder.. Thats about 10K just there. And thats not even an overly busy day for most doctors that start at 7am -6pm. Sure its not going to like that everyday for everyone.. but I think on average, thats not unusual for a big hospital.

Part of the pay disparity if also driven by our own society.. we have a very Kiasu society.. we want the best only, must ask 5 relatives and friends on who they think is the best... and I'm going to stick my neck out on this... but chinese patients are the worst for this.. picking and choosing.. want only the "best doctor", chinese doctor, cannot too old , cannot too young, don't want empty waiting room .. coz think he must not be good. They are willing to wait HOURS to see the person they think is good. This is the main cause of skewing effect seen in private, all the patients skew to the bigger centres.

doctors are not angels.. not by a mile. But I still believe most mean well and will genuine do what they can. The richer ones are more likely to waive their fees when patients cannot pay

If you really want to go into a national health route, with standardised doctor salary and all, then be prepared not to have any choice in your treatment. It will be dictated by cost based guidelines and what the government budgets says you can do. You will not be able to choose your doctor for his level of seniority or expertise. And you cannot easily get a second opinion in public service. If you want to maintain a scenario where you have an option to get your treatment faster or get the best treatment on offer, then you need private hospitals to fill the gap... And as long as there are private hospitals, this attitude of people to want the "best expert" for their money will continue, and in turn this will make the top 10% of doctors 200K/month earners..

as someone said, this is the same in all professions..

p/s: before anyone starts accusing me of race gaming.. I am qualified to make the statements above as I am Chinese. I have worked in both the public and private sectors , in university and MOH hospitals. I have also spent 10 years in the NHS.. so I know what I am talking about here.

Hey PY80,

Thanks for the detailed explanation, its really informative and sheds more light onto this issue.

I agree with you in that the private sector is a pay for service model hence enabling the top 10% of doctors to earn in the region of 200k per month. Like you said, around 60% of doctors still earn around 50-60k per month, which is a very comfortable amount. However I am just trying to comprehend how a middle income country in Malaysia could enable health professionals to earn these amounts, when similar countries with per capita gdp like ours don't have this phenomenon. The capacity to earn 10k a day for a one-man business still doesn't sound right to me, furthermore when we are discussing healthcare here. I understand that limiting a doctor's income is not the way, but I am of the view that some sort of national health financing scheme that covers both the public and private sectors should be implemented in Malaysia, like how Australia/UK is currently doing.

If the earning capacity enabled by our private hospitals remains this way, I don't know how will we stop the bleed of doctors from the government sector to the private sector. As I said, in the end the affected people will be Malaysians who can't afford to pay, and no one should be in a position whereby their health is compromised due to commercial reasons.

Race issues aside, I think you are slightly mistaken on the Royal College exams.

MRCS was not de-recognised in Malaysia the way you describe it, and certainly NOT because of racial issues.

The MRCS is a written exam only. Taken during your MO years. Purely theory and therefore not proof of qualitication as a surgeon. In the UK system its considered an entrance exam. This means if you didn't pass it, its very unlikely you will not be able to proceed into surgical training of any speciality.

After your MRCS, and once you completed your 5-6 year surgical training, you sit for an exit viva  exam. If you pass you will get the CCST and be awarded the FRCS. There is actually no such things as CCST post nominal. The post nominal is just FRCS (speciality). Some non-UK doctors may also carry the FRCS post nominal if they have been awarded the fellowship from the Royal College for outstanding achievement in their speciality.

The problem in Malaysia was that doctors were at the time were using the MRCS it as a recognition of specialist surgical training (in the same way the MRCP is used for internal medicine). This is totally flawed as surgical training is basically a structured apprenticeship program and not something you can just study and pass.

For internal medicine , its more knowledge based.. so for a long time, passing the MRCP(UK) meant you had achieved a certain level of clinical knowledge in general internal medicine. In the UK having the MRCP meant you could then pursue subspecialization , gastro, cardio, oncology, etc.

In Malaysia, due to lack of internal medicine subspecialist in the past, we maintained the general internal medicine physician to cover everything. and the MRCP with 4 years experience as an MO in general medicine was enough to gazette you as a specialist in general medicine.

In the UK there is no longer just a general physician. Everyone must continue into a subspecialty whereby there is another exit exam.. the MRCP SCE for each sub speciality.

Some non-UK subspecialists have also taken the MRCP SCE exam just to see if their knowledge is on par with the UK trained subspecialist.

The FRCP title is automatically awarded to UK consultants working in substantive posts within NHS hospitals after a period of time, the FRCP title can also be awarded to non-uk doctors if they show substantial contribution to their field of expertise.

Hope this clears up some ambiguity.

Many Malaysians are now pursuing medicine due to the perceived good life that they will have in the future, i.e. moving to private sector where they will earn big bucks. Eventhough the situation in the public hospitals are overwhelming, they always convince themselves that once they join the private sector, they will lead a comfortable life raking in big money.

My question I would like to post is, does anyone know how much these specialists can earn in private, like say KPJ or Pantai hospitals? Some say more than RM100k a month, some say reaching RM40k is also considered good. So let's have a discussion on this so that we would have future doctors who enter the profession for passion, not just money per se. Appreciate any input that you guys might have! Thanks

I have a good number of clients who are medical specialists. They start from RM40k a month and up

I can verify that this is correct. I am an Interventional Cardiology Registrar (ST7) in the UK, soon to be Consultant in 10 months' time (then balik Malaysia yahoo!) and it is a long training process. Gruelling, competitive, but I thrive on that so it was okay for me. Medicine / surgery is not for everyone. Don't think about the money only as someone wise told me once "no matter how rich you are, you can only eat 3 plates of koay teow a day".

I have been contacted by private hospitals back home offering good pay - 20K basic then after 6 months of settling in and building your practice, they claim they can pay 70K/month. If you bring in more work, the top guys in their hospital are earning 150K.

If that's all they are offering. I can tell you now you're being short changed.

Anyway, I think the whole thread has run off topic..

hope the info helps any budding doctor out there or those thinking about a career in medicine.

Holidays over, no time to reply now.. Take care guys.

I am happy to take PMs if anyone has any burning questions.

Hello, do you still take questions?
Do you mind sharing which medical or surgical specialty have the potential of earning >100-200k/month?

many thanks   

I can verify that this is correct. I am an Interventional Cardiology Registrar (ST7) in the UK, soon to be Consultant in 10 months' time (then balik Malaysia yahoo!) and it is a long training process. Gruelling, competitive, but I thrive on that so it was okay for me. Medicine / surgery is not for everyone. Don't think about the money only as someone wise told me once "no matter how rich you are, you can only eat 3 plates of koay teow a day".

You're misunderstanding what he is saying. They are not paying him a guaranteed 75-150k... That's what they expect him to EARN HIMSELF in the future. (Although it's tough). There's no fixed salary la.

He's saying they are offering him 20k salary to start off. Is called guarantee minimum income. And it comes with conditions. And is usually for a few months only to help you start off. That's where he's being short changed. 20k is considered a very low guarantee

You're misunderstanding what he is saying. They are not paying him a guaranteed 75-150k... That's what they expect him to EARN HIMSELF in the future. (Although it's tough). There's no fixed salary la.

He's saying they are offering him 20k salary to start off. Is called guarantee minimum income. And it comes with conditions. And is usually for a few months only to help you start off. That's where he's being short changed. 20k is considered a very low guarantee

Hi Bauer, do come back to Malaysia as our country needs more specialists! That's good pay, more than enough to live comfortably in Malaysia. How was the training process in the UK? And for comparison purposes, what is the salary range for consultants in the UK?

Cannot wait to come home. People jokingly say "hujan emas di negara orang, hujan batu di negara sendiri, lebih baik di negara sendiri" but I can tell you hand on heart, that is so so true once you have spent half of your adult life abroad.

Training process in the UK can be summed up in one word - organised. See, the content and exposure is probably just as good in Malaysia, but as is often the case with us as a nation (and this is a problem with other Asian countries too except maybe Singapore), we struggle with organising things and making things run well.

As a junior in the UK you get paid well, but as as a consultant you do not, in comparison to what you get paid as a consultant in Malaysia. In Malaysia, junior pay is shite for what you do, but consultant pay is damn too high for what you do.

I'll illustrate:

As a final year trainee (I graduated in 2010 and have therefore worked > 10 years - 2 years houseman, 2 years MO, 5 years registrar and an extra 2 years of a higher research degree i.e MD/PhD) I am now taking home 3900 GBP a month i.e. 20K ringgit.

As a consultant, normally first take home pay is around 4000 - 4400 GBP a month i.e. around 23K ringgit. This goes up every year for the first 5 years as a consultant by a few hundred pounds a month until the 5th year after which it plateaus. To get further rises, you have to get discretionary "points" - e.g. you improve a service in your department, or teach students, etc2. Basically extra stuff.

This of course means f*** all when you take into account the cost of living, so it is not quite a like for like comparison with Malaysia but you can see how the consultants here are not getting paid as well, compared to say someone in Pantai who can easily make 70K a month by doing very straightforward, less risky procedures (this tends to be the case as the indemnity is higher privately if you take on high risk patients and most people avoid this).

In summary, junior years are great here, consultant years are better in Malaysia. Having flexibility to move around is key in this profession, as with most things. This does require you to be good at what you do.

And before I forget, please do not view medicine/surgery as a way to be wealthy. The way to look at it is - you will never be poor. You can never say never of course because if you are an idiot and gamble away your wealth Bill Gates can also be poor! But the point here is, the stability that the profession provides is unrivalled. Covid-19 brings this to the fore and is a good example. I thank God every day that although my job is hard, I am still able to have a job anywhere in the world I go. When you go for your 20 year reunion you might not be the richest in your batch, but you certainly won't struggle. You might still make millions of course if you bantai lots of private work (some unethically!) , but the happiness that the stability provides while caring for patients is unrivalled in my view. Not to mention the intellectual stimulation.

In my very humble opinion:

1. If you're money minded, you will not find it easy to be a good doctor and make a lot of money at the same time. Although being a good doctor does not preclude the practitioner from becoming wealthy, the trajectory of wealth accumulation and generation will be vastly different to that of a successful businessman. It's not uncommon for passionate doctors to take a long time to accumulate wealth, as opposed to people in other professions. A lot of times, doctors make decisions against their own interests - because the patient's condition and illness demands such a conclusion. A simple example is do we give oral antibiotics for what is likely a simple viral infection of the throat with fever? If we don't, we lose out on the margin of profit from the sale of antibiotics, but if we do, we expose the patient to potential future antibiotic resistance because the antibiotics were given unnecessarily.

2. Doctors don't make good investors - because investors sometimes have to take risks to realise big gains, and doctors need to be risk adverse, as taking risks may end up harming the patient's outcome when a more conservative option would have been the safer decision. An example would be conservative treatment vs. surgical intervention for cervical spondylosis with radiculopathic pain. Conservative treatment involves analgesics, nerve relaxants, physiotherapy and the use of a soft neck collar. It's slow, boring and unexciting - but it's safe and most patients do eventually recover. Surgical intervention may involve laminectomy and disc/spine fusion and reconstruction and "cement" injections. With any surgery, there are risks involved - and the ultimate risk is the patient may end up being paralysed and a quadriplegic or a paraplegic. And, if you find yourself armpit-deep in the red from your forays into the stock market, would you then be tempted to push the envelop of risk for your patients, in order to recoup the paper losses?

3. In an ideal medical scenario, money and medicine are mutually exclusive - medical care is given solely only to those who need it, not to those who can best afford to pay a premium for it.

The attitude, character and personality required to be a successful - and dedicated - doctor is quite different from many other professions. I'm not the final judge or arbiter to say one is better to the other; in fact, it's merely different. You'll have to find the profession &/or specialty that best suits your personality and character - otherwise, you may find it a miserable existence for the next 40 or so years of your working life.
bauer, truer words were never spoken. Well done & welcome back to Malaysia.

Thanks a lot for your reply. I can see where you coming from. Definitely, Im not trying to make a specialty choice based solely on this factor. The reason financial remuneration can be a discerning factor is when, say, one loves medicine and some procedures in one's career, so one cannot decide on nephro or cardio then if cardio has better earning potential, why not go for cardio? Besides, by earning potential, I mean earning within the legal and ethical boundaries. Surely, within this context, from what I know, some specialties working for the same hours can earn higher pay than some other specialties, perhaps because of higher patient demand, or perhaps of unfair fee schedule. What I would like to do is to avoid those specialties, where you work as hard as other specialties but somehow the earning is relatively low.

Unless you are trying to tell me there is no such difference among different specialties, you can earn as much as you want regardless of your specialties, then my question would be reasonable. Just as we all know, some specialties are well-known for having higher compensations compared to other specialties even though all specialties work equally hard. For example, salary surveys from US have like ortho, neurosurg, cardio, cardiothoracic consistently on top of their lists across many years. The difference between these top earning specialties and the low earning specialties can be huge. So are those data relevant in Malaysia private context? Or would you say, in Malaysia, most are roughly the same, there is not so much variation among different specialties?

Thank you very much.