Thank you so much for sharing this. Appreciate it, keep them coming

Why don't most, if not all government based specialist that are not bound to their contracts quit their positions in the GH and make more moolah?

How does MoH retain these specialists, as I am told that the bests are always in government hospitals? Was I misled?

High risk high reward

Refer to my first post here.
As mentioned it's not easy for one to go to private if you don't have the backings of peer.

Majority who stay also are those who chose pencen. And u know which majority race choose that.

And for reasons that sensitive to divulge here.

There are also the bests of specialists who chose to stay but are also doing locum and visiting consultant in private hosp.

Masters of surgery.
The old FRCS was derecognised late 1990s early 2000s. Because majority of ppl who took the exam were Indians and Chinese.
U know, plotek plotek needed and things like that to give the other a chance.

Nowadays u become a medical officer
Start as a junior surgical trainee, proceed to intermediate or senior surgical trainee (chronic MO)

Enter the programme based on some selective criteria that is also biased i. E cable cable skin color and also CV (usually takes 2 to 6 years upon completion of HO and start of MO)

Now u start life as Registrar. Upon completion of programme you are now a gazetting specialist (surgeon)
5 years of life as surgeon automatically labelled consultant.

The journey takes about 10 years on average from your starting work life. Another 2 or 3 to consolidate cutting skills.

I disagree with msian route. I believe a competent surgical trainee needs to pass the MRCS (old FRCS) during junior trainee years, enter the masters programme, complete it. A better accomplishment is also to finish the new FRCS (I. E urol, tr and orth, plastics, Ent, OMFS, Gen surg to name a few)

Because for example a masters trained surgeon will only focus on his subject. If orthopaedics he will only know about bone bone and bone but an all round surgeon should have the base covered like in the UK by passing the MRCS that assesses a surgical trainee core topics. Because a surgeon that deals with limbs may also deal with say, burn injury, skin grafting and flap coverage of the plastic surgery.

Hence if you see your surgeon has the new qualification of the sub specialty FRCS and if from UK CCST rest assured you are in good hands.

But I go search ifrcs one of the criteria is that the candidate must have completed Training position in their home country

I tot FRCS is recognised in Malaysia for registration with NSR?
A lot of old timer with nothing but FRCS and loads of experience.

Thanks for understanding man, appreciate it. I am of the opinion that the majority of doctors in private hospitals earn rm50-80k, as only a select few would be able to break the rm100k ceiling if they are well-known and really good. I do agree that limiting a doctor's income would be a communalistic approach and it disincentives hardwork, but I have come across many stories, and I have experienced it myself, of some private doctors pushing medications and recommending unnecessary procedures the moment that they know you have insurance. This is not how a healthcare system should be run because it adversely impacts a patient's wellbeing too if the doctor only has money in mind. Majority of doctors enter private practice to earn more, and certainly these unethical practices is not something that Malaysians should condone.

The bad thing about our public sector is the severe underfunding that we have, as you have rightfully pointed out. However, doctors in public sector would definitely only do the needful pertaining to the patient's condition as money is not the primary goal. I agree with your treatment A and B example, but I am afraid that due to overcharging in private hospitals (due to overclaiming on insured patients and general costs of procedures), Malaysians who can't afford will only be able to go to public hospitals. It's a double edged sword, what more with the government removing the ceiling price for doctor's consultation fees. Malaysia still has a sizeable B40 population, and moving anywhere close towards the US healthcare system will be detrimental. I personally highly disagree with the US model on healthcare, and like you have rightfully said the UK's NHS is one of the best public healthcare model around.

I agree with you that if you want the best treatment, then you would have to pay for it. But like I said earlier in another post healthcare should not be run like a traditional business. Prices should be kept in check by gov to ensure that private hospital services will not reach a price point that is only affordable to the super rich or insured patients. Its through this lens that I raised this income issue because if left unchecked, doctors will just be greedier and try to make more as healthcare is not something that we can take for granted. I wholeheartedly agree with you on the public-private model, but it seems like our government is shifting further away from this ideal. Its a completely parallel systems now. However we should also note that private hospitals do not deal with complex cases amd in the end those cases will end up at the public hospitals. That's why as you have said, the government should increase the pay of public doctors to make it more attractive for them to stay, and also to reflect their workload and the complexity of cases they attend to.

Private hospitals is morphing into a system where profits come first and patient's wellbeing second. This is what I disagree with strongly and hence why doctors fees should not be allowed to reach a ridiculous level.  To be honest, even earning rm50-80k will place them within the top 1% of earners in Malaysia. I wonder what it takes for those doctors that earn rm100-200k, but im sure not many actually reach that level. And hopefully not by unethical practices! Ok now my post is too long too! Hahah😅 Let me know what you think!