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Criteria for Registering as Paediatrician in Malaysia

Any doctor can request to be registered as a paediatrician if he/she fulfils ALL the following
requirements:

1 A recognised basic medical degree

1.1 A basic medical degree recognized by the Malaysian Medical Council

2 A recognised postgraduate qualification


One of the following paediatric postgraduate degrees recognized by the Malaysian
Paediatric Specialty Committee:
2.1. M.Med (Paed) awarded by Universiti Malaya, Universiti Kebangsaan Malaysia or
Universiti Sains Malaysia
2.2. MRCP (UK) up to year 2000
2.3 MRCPCH by Royal College of Child Health UK
2.4 MRCPI (Ireland)
2.5 FRACP
2.6 M.Med in Paediatrics (Singapore)
2.7 Any other equivalent paediatric postgraduate degree recognised by the Malaysian
Paediatric Specialty Committee on a case to case basis

3 Completed postgraduate training in recognised centres

3.1 Minimum duration of training

3.1.1 Completion of a minimum of 4 years of paediatric training in centres which fulfilled the
criteria stipulated by the Malaysian Specialty Committee (refer to Appendix A) and under
the supervision of trainers who fulfilled the criteria stipulated by the Malaysian Specialty
Committee This period of training does not include the time the applicant spent during
his/her housemanship period.

3.1.2 The period of training received by the applicant can be either before or after acquisition
of the above postgraduate degrees.

3.2 Evidence of satisfactory postgraduate training as supported by:

3.2.1 Log book of core procedures (refer to Appendix B)

3.2.2 Portfolio, if any

3.2.3 Satisfactory supervisors’ reports on Clinical Core Competency (referred to Appendix C)


and core procedures (Appendix B)

3.3 For those practicing full time in the field of paediatrics and who obtained their post
graduate paediatric qualification as listed above at 1st September 2006 or earlier, their
application will be considered without the need for submission of log book and
supervisors’ report stipulated in 3.2.1 and 3.2.3if they fulfill ONE of the following
criteria:
3.3.1 Have been gazetted as a paediatricians by the Ministry of Health of
Malaysia. They are to submit a copy of the gazettement letter.
3.3.2 Have been registered as a paediatrician in the Specialist Register of the
Academy of Medicine of Malaysia
3.3.3. Have at least 4 years of supervised training in Paediatrics. References from
two credentialed paediatricians are required.
3.3.4. Have practised paediatrics full time for at least 5 years with certificate of
good standing from MMC. References from two credentialed paediatricians are
required.
Appendix A

Criteria of a centre where training in Paediatrics is recognised by the Malaysian


Paediatric Specialty Committee
(NB: This applies to applicants who were trained in overseas centres. For applicants trained in Malaysia,
please refer to the list of centres accredited for training by the Paediatric Subspecialty Committee.)

A. HOSPITAL Work load and services

1. Name of Hospital ________________________________________


(If you have been trained at a purpose built Children’s Hospital, omit items 2-5)

2. Total number of beds in the hospital _________ beds


(minimum 500)

3. Occupancy rate of beds in the hospital __________%


(occupancy rate >60%)

4. Total number of in-patients in the hospital per year _________ per yr


(Minimum 20,000)

5. Total number of out-patients seen at the hospital per year __________ per yr
(Minimum 100,000)

6. Does the hospital have the following clinical and supporting departments: (Please tick)
Medicine Yes [ ] No [ ]
Surgery Yes [ ] No [ ]
O&G Yes [ ] No [ ]
Orthopaedics Yes [ ] No [ ]
A&E Yes [ ] No [ ]
Blood bank Yes [ ] No [ ]
Pathology lab Yes [ ] No [ ]
Microbiology lab Yes [ ] No [ ]
Radiology department with ultrasound Yes [ ] No [ ]
and contrast study facilities

(These represent the minimum supporting departments that must be available)

7. Total number of accredited specialists/consultants in each of the following specialty in the


hospital
(At least one in each department)

Number Consultants Number


Consultants
Physicians (Internal Medicine) Obstetricians/Gynaecologists
Orthopaedic Surgeons General Surgeons
Pathologists Radiologists
Anaesthesiologists Microbiologists

8. Number of hospital clinical meetings _____ per month


(At least once a month)
9. Does the hospital have
a) night duty rooms for doctors Yes [ ] No [ ]
Comments ______________________________________________________
______________________________________________________

b) medical library Yes [ ] No [ ]


Comments _______________________________________________________
_______________________________________________________

c) meeting room with audio-visual aids Yes [ ] No [ ]


Comments _______________________________________________________
_______________________________________________________

B. Criteria of the PAEDIATRIC DEPARTMENT or CHILDREN’S/MATERNITY


HOSPITAL

1. Total number of general paediatric beds _____ beds


(Minimum 30 occupied beds daily. This includes HDU, ICU, day care & surgical beds
PROVIDED the paediatric unit is actively involved in daily care)

2. Total number of neonatal beds ______beds


(Minimum 15 occupied daily beds)

3. Does the hospital have Level III neonatal care Yes [ ] No [ ]


Comments ___________________________________________________________
___________________________________________________________

6. Number of ventilators in the neonatal intensive care unit _____ ventilators


(Minimum 3 in use)

7. Total number of out-patients (general paediatric & neonates) per year ________per yr
(Minimum 5,000/yr)

8. Number of service medical officers in Paediatrics unit ______


(Minimum 2, excluding Master of Medicine candidates)

9. How many days per week does a Paediatrician visit each ward? _____ days/wk
(Minimum 5/week)

10. Total number of outpatient clinics per week _______ per wk


(Minimum 4, including 2 subspecialty clinics)

Please furnish a copy of the current weekly clinic schedule and call roster for the
department

11. Departmental teaching activities

Please furnish a copy of the department’s current weekly or monthly teaching activities

a) Number of Journal club per month ______ per month


(Minimum once/mth)
Comments_____________________________________________________
_____________________________________________________

b) Number of clinical audit per month _______per month


(Minimum once/mth)
Comments _____________________________________________________
_____________________________________________________

c) Number of grand ward round per month ______ per month


(Minimum once/week)
Comments _____________________________________________________
_____________________________________________________

d) Number of department clinical conference per month ______ per month


(Minimum once/fortnight)
Comments _____________________________________________________
____________________________________________________

e) Other teaching activities (please indicate type and frequency per month):

12. An accredited trainer/supervisor for training of paediatricians in Malaysia is one who has
fulfilled all the criteria for registering as a Paediatric Specialist with the Malaysian Specialist
Register( In future, this will be changed to one who has registered with the Malaysian Specialist
Register) and has been practicing for at least 2 years in one of the Hospitals which fulfilled the
criteria stipulated above. A trainer can only have 2 trainees at any one time.
Appendix B

Core procedural skills acquired by a specialist upon completion of training in


Paediatrics

Skills in resuscitation of newborn infants, as supported by a valid Certificate of successful


training in Neonatal Resuscitation (NRP certificate) or its equivalent.

Skills in resuscitation of children (a Valid Certificate of Paediatric Advanced Life Support is


desirable)

Core Procedure Skills on Completion of Specialist Training in Paediatrics

Procedure Completed Signature of


supervisors/designation
1 Lumbar Puncture
2 Chest tube insertion
3 Suprapubic aspiration of urine
4 Basic ventilation indication, set up
Conventional
CPAP
5 Surfactant administration
6 Endotracheal intubation
7 Central venous/long line insertion
Femoral
Jugular
8 Arterial puncture/cannulation
9 Bone marrow aspiration and
trephine biopsy
10 Intraosseous cannulation
11 DC cardioversion/defibrillation
12 Peritoneal dialysis
13 Umblical artery and vein
cannulation
14 Ultrasound brain
Basic ECHO for LV function
15 Neonatal resuscitation
NRP certified
Pals certified
16 Exchange transfusion
17 Vaccination
BCG
IM injection
SC injection
Mantoux Test
Appendix C
Post Module Assessment Summary
(To be completed after each module and a copy sent to the Credentialing Committee)

Name of trainee: …………………………………………………..

Duration of Training: From …../…../………. till …../…../………

Assessment Summary
1 2 3 4 5
Poor Borderline Satisfactory Good Excellent
1 Clinical competence
a) Inquiry skills
b) Diagnostic ability
c) Patient management
d) Technical skills
2 Knowledge
3 Professional
characteristics
4 Personal learning &
assignments
5 Conduct &
communication skills
6 Record keeping
7 Participation in
Teaching-learning
activities
a) Ward round
b) Clinic
c) Case presentation
d) Tutorial
e) X’ray/CPC/Audit,
Mortality conference
etc
f) Journal club
g) Teaching ability
8. Research and publication

8.1: Title of project:……………………………………………………

Initiated
In progress
Presented
Published

8.2 Title of project:……………………………………………………

Initiated
In progress
Presented
Published

Comments

Overall Assessment: Fail / Repeat module / Pass / Satisfactory / Excellent

…………………………………….. …………………..

Name & Signature of Trainer Date


DEFINITIONS OF CORE COMPETENCY ASSESSMENT

Please mark the box in the post-module assessment summary which corresponds with
your observations in each category. Please judge according to the criteria outlined below
and not according to your experience with other trainees under your supervision.

The category “excellent” is the “gold standard” by which the student should be judged.

1. Clinical Competence

a) Inquiry skills (obtaining data/information from history, physical examination and


investigations )

Excellent: Consistently elicits problem-related data from


patient and other relevant sources, stresses
important points, well organized approach.
Consistently elicits and interprets correctly all signs,
technical and organizational approach consistently
good.
Consistently plans and interprets investigations
appropriate to the problem with attention to
specificity, reliability, patient safety and comfort,
cost and explains reasons for and nature of
investigations to patient.

Good: As above but less consistently.

Satisfactory: As above, but sometimes concentrate on data not


related to the problem, sometimes omits to consult
other sources, occasionally misses important signs.
Occasionally request investigations not appropriate
to the problem and / or without attention to
specificity, reliability, etc, sometimes miss
important data.

Borderline: Approach not well organized, not always problem


related, frequently misses important data.
Approach technically imperfect and not very
systematic, frequently misses important physical
signs.
Frequently request investigations not appropriate to
the problem and/ or without attention to specificity,
reliability, patient safety, misses important data.

Paed-criteria/8/6/2007
Poor: Approach not organized, frequently problem
related, important data missed on most occasions.

Approach technically unacceptable and not


systematic, important signs missed on most
occasions.

Consistently makes inappropriate decisions in


ordering investigations, consistently misinterprets
and/ or misses important data.

b) Problem solving and decision- making skills

Diagnostic ability

Excellent: Consistently makes careful reasoned deductions


from available data (history, physical examination,
investigations) to arrive at the appropriate decision.

Good: As above, but less consistently.

Satisfactory: As above, but occasionally makes incorrect


deductions. Most times able to give correct
provisional diagnosis but not all relevant differential
diagnoses.

Borderline: Frequently does not follow a logical approach to


deduction from the available data, frequently gives
incorrect provisional diagnosis.

Poor: Illogical reasoning and deductions. Frequently


makes incorrect diagnosis.

Patient Management

Excellent: Consistently suggests appropriate management,


exhibits awareness of the role and possible
complications of the proposed intervention (e.g
adverse drug reaction, treatment morbidity),
self-reliant and conscientious in approach, involves
patient and family in management decisions.

Good: As above, but less consistently.

Satisfactory: As above, but occasionally suggests inappropriate


management.

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Borderline: Shows some lack of awareness of role of proposed
interventions and their possible complications, is
unsure/not conscientious in implementing
management.

Poor: Frequently makes inappropriate management


decisions.

Technical skills

Excellent: Consistently carries out procedures and operative


tasks with an appropriate level of technical skill and
with due consideration for the patient.

Good: As above, but less consistently

Satisfactory: As above, but is not equally skilled in all procedures

Borderline: Not skilled in most procedures, occasionally


exhibits lack of consideration and/or care and
attention to detail.

Poor: Serious lack of skill in a number of procedures,


frequently exhibits lack of care and attention to
detail, not considerate to patients.

2. Knowledge

Excellent: Consistently applies appropriate knowledge of basic


and clinical sciences to the solution of patient
problems. Demonstrates maturity and initiative for
self-directed learning in problem solving.

Good: As above, but less consistently

Satisfactory: As above, but occasional gaps in knowledge and/or


difficulty in application to patient problems.
However makes effort to seek information.

Borderline: Inadequate knowledge and/or difficulty in


application to patient problems. Sometimes make
effort to seek information.

Paed-criteria/8/6/2007
Poor: As in borderline but lacks initiative in seeking
information.

3. Professional Characteristics

Excellent: Shows evidence of professional qualities: accepting


responsibility, being caring, thorough, reliable,
available, punctual, trustworthy and respecting
confidentiality

Good: As above, but less consistently or as effectively.

Satisfactory: As above, but with occasional deficiencies in


professional qualities as defined above.

Borderline: Frequently deficient in areas defined above.

Weak: Consistently deficient in areas defined above.

4. Personal Learning and Assignments.

Excellent: Consistently manages own learning by asking


questions and searching for the answer in journals,
books and consultation, improves progress as a
learner and as a future physician by seeking
feedback and acting on the latter, willing to teach
others, conscientious in completing assignments :
case write ups, audits, log book, dissertation.

Good: As above, but less consistently or as effectively

Satisfactory: As above, but with occasional deficiencies in self


directed learning, self monitoring

Borderline: Frequently deficient in areas defined above.

Poor: Consistently deficient in areas defined above.


5. Conduct and communication skills

Excellent: Consistently in communication with patients, listens


and is sensitive to the needs of the patient; comforts
the patients; gives equal priority to the person and
the illness; establishes and maintains an open but
objective relationship with the patient; recognizes

Paed-criteria/8/6/2007
that the patient’s attitude to the doctor affects
patient’s reactions/behaviour; provides clearly
understood information.
Consistently communicating/working with other
professionals, is courteous, sensitive to needs of
others; fulfils role in the team appropriately by
collaborating readily with others; provides clear
information, instruction/advice to others; readily
accepts reasonable advice/criticism from others.

Good: As above, but less consistently or as effectively

Satisfactory: As above, but with occasional deficiencies in


communicating skills outlined above.

Borderline: Frequently deficient in communicating skills


outlined above.

Poor: Consistently deficient in communicating skills


outlined above.

6. Record Keeping

Excellent: Consistently records legibly, updates accurately


patient’s problems and management progress, with
emphasis on own observations, and provides regular
informative summary of progress.

Good: As above, but less consistently.

Satisfactory: As above, but occasionally one or more aspects of


record keeping inadequate.

Borderline: Records are frequently illegible, not up-to-date,


inaccurate, and poorly organized.

Poor: Records are consistently inadequate according to


above criteria.

7. Participation in Teaching-learning Activities.

Paed-criteria/8/6/2007

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