Disaster Management and Emergency Medicine in Malaysia

摘要

R esident ’ s S ection Disaster Management and Emergency Medicine in Malaysia Sharon Lee, MD University of California, Irvine School of Medicine, Department of Emergency Medicine, Orange, CA development of this system, there would be an improvement in the referral system and delivery of care particularly to the rural areas. There has also been the recent successful establishment of “1 Malaysia Clinics” in 2010, which operate nationwide and offer medical treatment for common illnesses such as fever, flu and colds. They have received encouraging responses from patients, thus reducing the number of patients at Government Hospitals. This year, one of the newest members of the University of California, Irvine (UCI) emergency medicine department joined us from Malaysia. Dr. Rosidah Ibrahim heads the Emergency and Trauma department at Hospital Serdang, located in Selangor, Malaysia, approximately 15 miles from the Malaysian capitol of Kuala Lumpur. She is the newest International Disaster Medical Sciences fellow at UCI. She holds many leadership positions in Malaysia’s Ministry of Health and is a member of the Steering Committee for the Emergency Medical Services, head of the committee on Pre- hospital care services, head of the technical committee for the government development of emergency services system, and head of the disaster management committee. I had a chance to ask her about her experiences as a Malaysian emergency medicine physician and her international disaster management experiences. What is training for physicians and specifically for emergency medicine physicians in Malaysia? Following completion of undergraduate studies, candidates undergo a two-year internship (or housemanship) training at identified hospitals with mandatory rotations of four months duration in medicine, surgery, pediatric, orthopedic, obstetric/gynecology and emergency medicine. Physicians are required to perform two years of housemanship and two years of government service with public hospitals. The Emergency Medicine Master Program, a four year training program, was first established in 1998. Candidates are eligible to apply upon completion of their housemanship. The training consists of two years in emergency medicine and two years in various specialties including general medicine, cardiology, general surgery, neurosurgery, orthopedic, obstetric/gynecology, pediatric, anesthesiology, radiology, ophthalmology, etc. After successfully completing the postgraduate training, they undergo a compulsory gazettement (or probationary) period of six months to two years under the direct supervision of a Consultant Emergency Physician before they are registered as specialists. Specialists have less than five years of working experience, Consultants have five to seven years of experience, and Senior Consultants have more than seven years in the specialty. Please describe the health care system in Malaysia. What are some of the health care problems that the country faces? Malaysia has a very comprehensive range of the health services and is divided into private and public sectors. Healthcare in Malaysia is mainly under the responsibility of the government’s Ministry of Health, which offers quality health care through wide varieties of nationwide networks of clinics and hospitals. Primary care services are delivered at the government clinics by a team of family medicine physicians, nurses and assistant medical officers. Patients need to be referred for specialist care. There is still, however, a significant shortage in the medical workforce, especially of highly trained specialists; thus, certain medical care and treatments are available only in large cities. The Ministry of Health tries to overcome this by improvements including the refurbishment of existing hospitals, building and equipping new hospitals, expansion of the number of polyclinics, and improvements in training and expansion of telehealth. A major problem with the health care sector is the lack of medical centers in rural areas, which the government is trying to counter through the development of and expansion of a system called “tele-primary care.” With the Volume XII, no . 1 : February 2011 Please describe your emergency medicine department at Hospital Serdang and your typical patient population. CAL/AAEM Newsletter.