ANNEX D1

ARF DiREx 2015 Medical

License
LICENSES AND CLEARANCES
Medical Licensing and Credentials
Regulations over foreign health workers are enforced by Ministry of Health
(MOH) Malaysia, along with the Malaysian Medical Council.
APPLICATION FOR TEMPORARY PRACTISING CERTIFICATE (TPC)
GENERAL INFORMATION AND GUIDELINES
A Temporary Practising Certificate (TPC) is issued under Section 16(1) of the
Medical Act
1971.
Section 16(1) : Notwithstanding anything to the contrary contained in this Act,
the Council
may, upon application in writing, issue to a person who is registered as a medical
practitioner outside Malaysia a temporary certificate to practice as a medical
practitioner,
subject to such conditions and restrictions as the Council may specify in such
certificate, for
a period not exceeding three months.
A. Objective of TPC:
To enable a medical practitioner to practice medicine for a period not more than 3
months in Malaysia. An extension may be considered on application.
B. Purpose of TPC:
1. To conduct courses/seminars/workshops
2. To undergo clinical training/fellowships/masters programs in local
universities/medical institutes.
C. Application for TPC:
1. A practitioner registered with the Malaysian Medical Council with valid and
current Annual Practising Certificate must complete an application form in full.
2. The application must be accompanied by list of documents stated.
D. Processing of TPC:
1. Application will be forwarded to the Evaluation Committee for evaluation.
2. The institute will be notified in writing on the Evaluation Committees decision.

ANNEX D1
E. Important Notice:
1. Please ensure that your application is submitted at least 6 (SIX) WEEKS prior
to date of commencing practice as the Evaluation Committee sits only once a
month.
2. Application must be tendered in 7 (SEVEN) COPIES.
(NOTE: Only one set needs to be original certified true copy.)
3. This application must be filled by the institution applying.
4. Submit this application and documents required via Diplomatic Channel to:
ASEAN-Malaysia National Secretariat
Ministry of Foreign Affairs, Malaysia
LIST OF DOCUMENTS FOR SUPPORTING THE TEMPORARY PRACTISING
CERTIFICATE (T.P.C.) APPLICATION UNDER SECTION 16 OF THE MEDICAL
ACT, 1971
1. Application form for T.P.C. (to be type written)
2. Curriculum Vitae of the applicant (to be type written)
3. Certified true copy of basic medical degree.
4. Certified true copy of post graduate degree(s)
5. Certified true copy of full registration certificate from Medical Council or
Medical
Licensing Authority of the country of practice.
6. Current and original Letter of Good Standing from Medical Council or Medical
Licensing Authority of the country of practice.
7. Certified true copy of testimonials of working experience from the completion
of
housemanship until now.
(Note : Every working experience given in the curriculum vitae must be supported
by
certified true copy / copies of testimonial from Head of Department/ supervisor
concerned)
8. Certified true copy of Passport (in A4 size paper).
9. Certified true copy of Medical Indemnity.

ANNEX D1
IMPORTANT TO SUBMIT YOUR APPLICATION AT LEAST 6 WEEKS IN
ADVANCE
OF THE DATE ON WHICH YOU WOULD LIKE YOUR TPC TO BEGIN.

APPLICATION FOR TEMPORARY PRACTISING CERTIFICATE (T.P.C)

UNDER
SECTION 16 OF THE MEDICAL ACT, 1971
INSTITUTION APPLYING:
1. Name:
.
2. Address: ....................................................
.
.........................................................
3. Tel. No: ................................................ Fax No: ........................
....................
4. Department:............................................................
LOCAL REGISTERED PRACTITIONER RESPONSIBLE FOR THE
APPLICANT WHILST
PRACTISING IN MALAYSIA:
DEPUTY DIRECTOR GENERAL OF HEALTH (MEDICAL),
MINISTRY OF HEALTH MALAYSIA.
FOR ARF DIREX 2015 USE ONLY

ANNEX D1
CURRICULUM VITAE OF PRACTITIONER APPLYING FOR TPC:
8. Name (in Full and Capital Letters): ............
....................................................
9. Citizenship: .........................................................
....
10. Basic Medical Qualification:
a. University Awarding the Basic Medical Degree: ..
b. Year degree awarded: ...
11. Post Graduate qualification/s:
a. University Awarding the Postgraduate Medical Degree:
..
b. Year degree awarded: ...
12. Licensing Authority:
a. Name of Registering Medical Council or Licensing Authority in Country of
Practice:
...
b. Full Registration No. : ................ Date issued : ........../............./..................
c. Letter of Good Standing:
Number:

...................
Date

issued : ....../............./.................
Date

expired: ........./............./.................
d. Medical Insurance Coverage: (Note: Please submit certified true copies)
Name

of Medical Insurance Body: ...................

Certificate

No. : ....../............./.................
Date

expired: ........./............./.................

PURPOSE, PLACE AND PERIOD OF TPC:

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ANNEX D1

13. Purpose for applying TPC: (please tick one)

FOR ARF DIREX 2015 USE ONLY
14. Place and Period of Practice: (Not more than 3 (three) months)
ARF DIREX IN PERLIS, MALAYSIA : FROM 25TH 29 MAY 2015 ONLY
DECLARATION: (To be signed by the Local Registered Medical Practitioner)
I hereby agree to assume full responsibility for the management of patients
treated by the
applicant Dr. .... during his period of
practice in
this country.
Signature : ............................................ Date : ........./............/...
Name of Local Practitioner: ...........................
Rubber stamp of the applying institution:
LIST OF DOCUMENTS FOR SUPPORTING THE TEMPORARY PRACTISING
CERTIFICATE (T.P.C.) APPLICATION UNDER SECTION 16 OF THE MEDICAL
ACT,
1971
1. Application form for T.P.C. (to be type written)
2. Curriculum Vitae of the applicant (to be type written)
3. Certified true copy of basic medical degree.
4. Certified true copy of post graduate degree(s)
5. Certified true copy of full registration certificate from Medical Council or
Medical Licensing
Authority of the country of practice.
6. Current and original Letter of Good Standing from Medical Council or Medical
Licensing
Authority of the country of practice.
7. Certified true copy of testimonials of working experience from the completion
of housemanship
until now.
(Note : Every working experience given in the curriculum vitae must be supported
by certified
true copy / copies of testimonial from Head of Department/ supervisor
concerned)
8. Certified true copy of Passport (in A4 size paper).
9. Certified true copy of Medical Indemnity.
IMPORTANT TO SUBMIT YOUR APPLICATION AT LEAST 6 WEEKS IN
ADVANCE OF
THE DATE ON WHICH YOU WOULD LIKE YOUR TPC TO BEGIN.

ANNEX D1
MEDICAL RESPONSE
Objectives of the Medical Response
1.

To enhance confidence and to develop mutual understanding among

ARF participants in the context of multinational disaster relief
operations by active involvement in various medical activities.

2.

To strengthen multinational medical response through organized

collaboration and teamwork of all medical activities which includes:
Needs Assessment
Triage
First-Aid & Emergency Medical Treatment
Patient Movement & Evacuation
Mental Health & Psychosocial activities
Forensic activity

3.

To address each others needs and concerns during humanitarian aid

assistance.

4.

To establish an organized coordination system in multinational medical

response for future mission.

5.

To improve civilian-led military-supported disaster operations and civilmilitary coordination at operational and tactical level.

MEDICAL OPERATING MANUAL ARF DiREx 2015

1.

2.

Overview
1.1

ARF DiREx 2015 is an opportunity for ASEAN countries to prepare

medical team in facing disasters in a well-coordinated civil-military
approach.

1.2

Medical activity is considered to be one of the most important

components of disaster response due to the fact that it is directly
related to life saving activities.

Structure
2.1

Medical Incident Coordinator (MIC) is stationed at EOC during the

disaster response.

ANNEX D1

3.

2.2

Only appointed officials can operate at the EOC.

2.3

Medical Scene Controllers shall coordinate and control the medical

activities during the exercise.

2.4

On Scene Medical Commander (OMC) shall be the overall

commander for all medical related activities at site.

Accommodation
3.1 Every medical team will lodge at the appointed venue (hotel) as per
registration.
3.2 For camping, please follow the SAR operating manual.

4.

Logistics
4.1

Medicines

4.1.1 All participants are advised to bring along their own prescribed
medicines.
4.1.2 If the need arise, emergency medical treatment shall be provided
by the Malaysian medical team.
4.2

Oxygen

4.3.1 4.2.1 Oxygen shall be provided via appointed Liaison Officer once
request is made. Cost shall be borne by participating countries
4.4

Electricity/Generator Set & Fuel

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ANNEX D1

4.4.1 SAR medical team should be self-sufficient in providing own

electricity supply.
Cost of additional fuel supply shall be borne by participating
countries upon request made to appointed Liaison Officer
4.5

Food

4.4.1 All participants are expected to have their own personal packed
ration.
4.6
5.

Communication
5.1
5.2
5.3
5.4

6.

Each participating team will have to bring their own communication

devices.
It is advised to have English speaking personnel from each
participating country.
Interagency communication among medical personnel shall be
done through an elected liaison officer under the command of
Malaysian Medical Officer Liaison Officer (MELO).
Countries who plan to utilize own radio communication system are
advised to get approval from host country.

Refreshments and Restroom Facilities

6.1

7.

Water for field hospital will be provided by host country.

Refreshments and portable water will be provided for all exercise

participants throughout the exercise. Restrooms facilities will be
available at each venue.

Assignment & Report

7.1

7.2
7.3

7.4

Upon arrival into the host country, the leader of each medical team
shall report to EOC. MIC (Medical Incident Coordinator) at EOC
shall coordinate further arrangement for deployment of the teams to
the site.
Each dispatched medical team shall elect a team leader and this
must be made known to the MIC.
At the incident site, team leader must first report to the OnScene
Commander (OSC) which is the police and once entry to site
ground is obtained to report to the On Scene Medical Commander
(OMC) and work under the command and coordination of the OMC
during their duration of stay.
All Medical team response deployment at the incident sites shall be
coordinated by the OMC.
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ANNEX D1

8.

Temporary License
8.1

8.2
8.3
8.4
9.

10.

All Medical Team members are requested to apply for the

Temporary Practising Certificate ( TPC) available in the ARF Direx
Website. This process is only valid for the duration of the ARF
DIREX and only to be used for DIREX purposes only. ( TPC Forms
available in the above section on pages 5 and 6)
The registered team members are only allowed to treat the
simulated victims in the exercise.
All real victims shall be attended to by the Malaysian medical team
on standby at each site.
Foreign medical teams do not require a temporary license to treat
personnel from their own country.

Type of Mission
9.1

Medical activities at the incident site:

9.1.1 Medical Rescue activities
9.1.2 Triage
9.1.3 First Aid and Emergency Medical Care
9.1.4 Patient movement & Evacuation
9.1.5 Mental Health & Psychosocial activities
9.1.6 Forensic activities

9.2

Establishment of forward medical post, medical base station and

field hospital.

9.3

Only trained and well equipped medical personnel are allowed to

enter the red zone to assist in SAR activities.

Real Patient Medical Treatment

10.1
10.2
10.3
10.4

Real patients will be attended to by the Malaysian medical standby

team at each site.
If required, real victims shall be evacuated to the designated
hospital.
Transportation of real patients shall be coordinated by the medical
scene controller assisted by the medical standby team at each site.
In the event of the occurrence of real victims, the medical scene
controller has the duty to inform the MIC at the EOC.

ANNEX D1
11.

Field hospitals
11.1
11.2
11.3

Field hospital shall be set up in order to provide virtual casualties

with necessary medical care .
The field hospital should be able to provide operation and
hospitalization facilities.
The level of field hospital is to follow the Medical Support Manual
for United Nations Peacekeeping Operation (Chapter 3, 3.04Structure of medical support in peacekeeping Operation pg 19-22)
as stated below:

STRUCTURE OF MEDICAL SUPPORT

A. Basic Level.
This effectively refers to basic First Aid and preventive medicine practised. As
there is no doctor present, care is provided by a trained paramedic or nurse,
using basic medical equipment and supplies.
B. Level One Medical Support.
This is the first level where a doctor is available. It provides first line primary
health care, emergency resuscitation, stabilization and evacuation of casualties
to the next level of medical care within a peacekeeping mission.
A Level One medical unit is to have adequate medical supplies and consumables
for up to 60 days.
Tasks of Level One Medical Unit:
1. Provide primary health care with the capacity to treat at least 20 ambulatory
patients per day.
2. Perform minor surgical procedures under local anaesthesia, e.g. toilet and
suture of wounds, excision of lumps.
3. Perform emergency resuscitation procedures such as maintenance of airway
and breathing, control of hemorrhage and treatment of shock.
4. Triage, stabilize and evacuate a casualty to the next level of medical care.
5. Ward up to 5 patients for up to 2 days each, for monitoring and inpatient
treatment
6. Administer vaccinations and other disease prophylaxis measures required in
the mission area.
7. Perform basic field diagnostic and laboratory tests.
8. Maintain the capability to split into separate Forward Medical Teams (FMTs) to
provide medical support simultaneously in two locations.
9. Oversees implementation of preventive medicine measures for the contingents
and personnel under their care

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ANNEX D1
Level Two Medical Support.
This is the next level of medical care and the first level where surgical expertise
and facilities are available. The mission of a Level Two medical facility is to
provide second line health care, emergency resuscitation and stabilization, limb
and life-saving surgical interventions, basic dental care and casualty evacuation
to the next echelon.
Tasks of Level Two Medical Unit:
1.
Provide primary health care with the capacity of treating up to 40
ambulatory patients per day
2.
Perform limb and life saving surgery such as laparotomy, appendectomy,
thoracocentesis, wound exploration and debridement, fracture fixation and
amputation. This must have the capacity to perform 3-4 major surgical
procedures under general anesthesia per day.
3.
Perform emergency resuscitation procedures such as maintenance of
airway, breathing and circulation and advanced life support, hemorrhage control,
and other life and limb saving emergency procedures.
4.
Triage, stabilize and evacuate casualties to the next echelon of medical
care.
5.
Hospitalize up to 20 patients for up to seven days each for in-patient
treatment and care, including intensive care monitoring for 1-2 patients.
6.
Perform up to 10 basic radiological (x-ray) examinations per day.
7.
Treat up to 10 dental cases per day, including pain relief, extractions,
fillings and infection control.
8.
Administer vaccinations and other disease prophylaxis measures as
required in the mission area.
9.
Perform up to 20 diagnostic laboratory tests per day, including basic
hematology, blood biochemistry and urinalysis.
10.
Constitute and deploy at least 2 FMTs (comprising 1 x doctor and 2 x
paramedics) to provide medical care at secondary locations or medical support
during land and air evacuation.
11.
Maintain adequate medical supplies and consumables for up to 60 days,
and the capability to resupply Level One units in the Mission area, if required.
D. Level Three Medical Support.
This is the highest level of medical care provided. It combines the capabilities of
Level One and Two units, with the additional capability of providing specialized
in-patient treatment and surgery, as well as extensive diagnostic services. It is
important to note that a Level Three unit is rarely deployed, and that this level of
support is generally obtained from existing civilian or military hospitals within the
Mission area or in a neighboring country.

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ANNEX D1
Tasks of Level Three Medical Unit:
1. Provide primary health care with the capacity to treat up to 60 ambulatory
patients per day.
2. Provide specialist medical consultation services, particularly in areas like
Internal Medicine, Infectious Diseases, Tropical Medicine, Dermatology,
Psychiatry and Gynaecology.
3. Perform up to 10 major general and orthopedic surgical procedures under
general anesthesia per day. Availability of specialist surgical disciplines (e.g.
neurosurgery, cardio- thoracic surgery, trauma surgery, urology, burns unit) is an
advantage.
4. Perform emergency resuscitation procedures such as maintenance of airway,
breathing and circulation and advanced life support.
5. Stabilize casualties for long-haul air evacuation to a Level 4 facility, which may
be located in another country.
6. Hospitalize up to 50 patients for up to 30 days each for in- patient treatment
and care, and up to 4 patients for intensive care and monitoring.
7. Perform up to 20 basic radiological (x-ray) examinations per day. Availability of
ultra-sonography or CT scan capability is an advantage.
8. Treat 10-20 dental cases per day, including pain relief, extractions, fillings and
infection control, as well as limited oral surgery.
9. Administer vaccination and other preventive medicine measures, including
vector control in the mission area.
10. Perform up to 40 diagnostic laboratory tests per day.
11. Constitute and deploy at least two FMTs (comprising 1 x doctor and 2 x
paramedics) to provide medical care at secondary locations or medical support
during casualty evacuation by land, rotary and fixed-wing aircraft.
12. Maintain adequate medical supplies and consumables for up to 60 days, and
the capability of limited resupply Level One and Level Two medical units, if
required.
E. Level Four Medical Support.
A Level Four medical facility provides definitive medical care and specialist
medical treatment unavailable or impractical to provide for within a Mission area.
This includes specialist surgical and medical procedures, reconstruction,
rehabilitation and convalescence. Such treatment is highly specialized and costly,
and may be required for a long duration.

Indications for Level 4 facilities include:

1. When the distance from Mission area to the country of origin is too far, and the
patient or casualty is in urgent need of specialist medical treatment.

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ANNEX D1
2. When the patient requires only short-term specialist treatment and is expected
to return to duty within 30 days.
3. When the country is unable to provide appropriate definitive treatment (this
excludes chronic medical conditions diagnosed prior to the deployment into the
Mission area, or for which he is already receiving treatment).
F. Forward Medical Team.
A Forward Medical Team (FMT) is a small, highly mobile medical unit of about 3
men that is configured and equipped to provide short-term medical support in the
field. This is generally constituted as and when required from existing medical
units within the Mission area (including personnel, equipment and supplies.
.
Tasks of Forward Medical Team:
1. To provide primary healthcare and emergency medical services at a medical
post supporting a contingent of about 100-150 personnel.
2. To provide first line medical support for short-term field operations in areas
without immediate access to medical facilities.
3. To provide continuous medical care during land and/or air evacuation of
casualties particularly for seriously ill or unstable casualties, and where
evacuation distances are long or where delays are anticipated. This includes
medical evacuation out of the affected area.
4. To provide a medical team for Search and Rescue missions.
To function effectively in the above operations, it is important for FMTs to be well
equipped despite their size, including the requirement for life-support medical
equipment. All equipment and supplies need to be portable and configured for
use in confined spaces like ambulances and helicopters. There may be a
requirement for electrical equipment to be aviation-certified for use within aircraft.
12.

Referral hospitals
12.1
12.2

12.3

13.

Hospital Tuanku Fauziah in Kangar shall be the designated referral

hospital and primary receiving hospital. Hospital Sultanah Bahiyah
shall be the secondary responding hospital.
Virtual requests shall be made for patient movements from SAR
site and field hospital to referral hospital through the OMC.
However patient movement exercise ends when the patient gets on
designated transportation.
It shall not be activated during the exercise as it is only activated for
receiving real victims.

Forensic activities

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ANNEX D1
13.1
13.2
13.3

11.

Any death declaration and documentation can only be made by a

Malaysian medical practitioner.
All death must be reported to MIC who will then alert the relevant
authorities for further action.
Forensic activity can only be carried out by the Malaysian police
following host countrys SOP.

Real Emergencies
At site:
11.1
11.2
11.3

The standby medical team shall be responsible to render treatment

at site
The team shall also be responsible for the transportation of the
injured/ill person to the hospital if needed.
Hospital charges incurred shall be the participants responsibility.

Off site:
11.4
11.5
12.

All injured/ill participants shall be managed using the MERS999

emergency system.
The medical cost shall be borne by the patient.

Reporting
12.1

Medical scene controllers must submit a report upon completion of

each FTX to the medical exercise coordinator (MEC).

12.2

Foreign medical team should submit a final report to the MIC in

EOC.

RESPONSIBILITIES OF TTX & FTX MED WORKGROUPS

-

Formulate and finalized plans for all medical related activities at all
incident sites.
To provide medical assistance in case of any injury/illness among
participants.
Obtain permission for medical activities from relevant authority.
FTX FLOW FOR MEDICAL RESPONSE

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ANNEX D1

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16

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ANNEX D1
EXPECTED OUTCOME OF MEDICAL AND HEALTH MANAGEMENT

Improvement of medical service during disaster through the coordination

between all medical groups.
Reinforcements of national and international civil-military collaboration
during disaster response.

RESPONSIBILITIES OF STANDBY MEDICAL TEAM

Provide emergency medical care for participants in case of an actual

emergency
Responsible for the medical management of real injured/ill participants.
Provide patient transfer services by ambulances and/or helicopters and/or
boat to designated hospital.
Monitoring the health status of all members of rescue teams as well as
medical teams
Conduct forensic activities

18