Newcastle University Medicine Malaysia (NUMed) once boasted of providing medical graduates “your UK-certified medical future, right here in Malaysia”, touting the nation’s first and only MBBS degree “recognised in the UK”, on its website.
But after the United Kingdom’s Medical Training (Prioritisation) Act 2026 became law last March, resulting in all 103 NUMed graduates being placed on the reserve list for the 2026 UK Foundation Programme cycle, NUMed’s home page now says: “The Newcastle standard. Right here in Malaysia. At local fees.”
The impact of the UK’s new medical training law on the undergraduate level in Malaysia is minimal, since NUMed is the only university affected. Local students can easily do their housemanship in Malaysia since there are thousands of vacancies, while foreign students will have to return to their home country.
The bigger impact is on the Ministry of Health’s (MOH) parallel pathway programmes with UK royal colleges and other foreign institutions that number at about 18 specialist qualifications.
When asked about the impact of the UK’s Medical Training (Prioritisation) Act, the Royal College of Surgeons of Edinburgh (RCSEd) shockingly told CodeBlue that the cardiothoracic surgery parallel pathway was a “Malaysian qualification”, designed specifically to train surgeons for the Malaysian health care system.
Although a check of RCSEd’s previous public statements shows that the royal college never explicitly described the parallel pathway as a “UK qualification”, parallel pathway proponents, Members of Parliament, and the Government of Malaysia operated on a reasonable assumption that the qualification was of UK origin, even though graduates trained in Malaysia.
Malaysia’s Medical (Amendment) Act 2024, which lists FRCS Edinburgh in Cardiothoracic Surgery under Schedule 4 as a UK qualification, was birthed in an acrimonious debate between parallel pathway proponents and opponents.
Health Minister Dzulkefly Ahmad’s signature policy, which radically revamped specialty training in Malaysia through major legislative changes, was ironically triggered by the cardiothoracic surgery parallel pathway—only for the awarding institution to publicly disassociate its home country from the qualification.
Legal implications may occur if Schedule 4 isn’t amended to accurately reflect the “Malaysia” origin of FRCS Edinburgh in Cardiothoracic Surgery from the parallel pathway. The question about which local institution confers the qualification applies even if, or rather especially if, graduates plan to register as specialists in Malaysia.
If even kindergartens require regulation, what more licensing to authorise someone to perform heart surgery. So the Malaysian Medical Council (MMC) must specify the local institution that is legally responsible for awarding the FRCS Ed (Malaysian version) and whether it’s accredited to do so, whether it’s MOH, a medical fraternity, or RCSEd Malaysia Sdn Bhd that merely runs an administrative office here.
A lawsuit against MMC, headed by then-president and Health director-general Dr Muhammad Radzi Abu Hassan, kicked everything into motion in 2024. Two years later, parallel pathway opponents are now vindicated by the UK’s move to codify the prioritisation of her own people over foreigners in medicine.
This Shakespearean drama – which saw Malaysia bending over backwards for our former colonial masters, only to suffer betrayal – wasn’t entirely unforeseen. Alas, government leaders, MPs, and clinicians failed to heed the warnings.
“‘Tis the time’s plague when madmen lead the blind” — King Lear.
The British High Commission still touts education as an important pillar of the “longstanding relationship between the UK and Malaysia”.
Here’s another Shakespeare quote from Two Gentlemen of Verona:
“Thou common friend, that’s without faith or love,
For such is a friend now; treacherous man!”
Malaysian Doctor: ‘Priority For UK Citizens Before Foreigners’
A Malaysian friend of mine is currently working as a registrar in transplant surgery at Hammersmith Hospital in London, prior to working as a transplant registrar at Royal Free Hospital in the UK capital. A registrar is equivalent to a senior medical officer in Malaysia.
After a short stint as a medical officer here, he moved to Ireland where he did his core surgical training, before moving to the UK in 2023 because he couldn’t secure a training position in Ireland due to intense competition for limited posts.
“I’m not in training, but the UK has alternate routes where I can gather my competencies and fulfil the necessary requirements to get signed off as a specialist,” he told me.
He added that the UK’s Medical Training (Prioritisation) Act not only affects training positions, but also non-training jobs like his: “Priority for UK citizens first before opening up to foreigners.”
All jobs in the NHS, he said, are on a one-year contract.
No More Unique Selling Proposition Of UK Jobs
Given the UK’s treachery, why should Malaysia treat specialist qualifications from royal colleges as equivalent to our local Master’s programmes? Besides cardiothoracic surgery, other parallel pathways may also be affected and are considered “Malaysian” qualifications now.
If UK qualifications (obtained overseas) aren’t good enough for their home country, why should they be good enough for us?
We must end our embarrassing subjugation to British colonialism from the codification of “UK” specialist qualifications into Malaysian law, especially when royal colleges themselves, such as the RCSEd, have washed their hands of what they now term as “Malaysian” qualifications.
The Brits have a unique ability of giving backhanded moral lectures, with the UK’s Department of Health and Social Care (DHSC) raising “significant ethical concerns” to attracting doctors from poorer countries with very low numbers of doctors per population.
“It is therefore beneficial to other countries as well as the UK that we rely less on international recruitment,” says the DHSC in its explainer of the Medical Training (Prioritisation) Act.
It’s time that Malaysia began phasing out its parallel pathway programmes, beginning with UK royal colleges. Since various foreign qualifications under Schedule 4 of the Medical Act have recognition end dates, we can do the same for parallel pathway qualifications.
Whatever non-parallel pathway foreign qualifications (i.e. obtained from training in the home country of that institution) can remain in our Medical Act to allow Malaysians who studied abroad to return to practise in their homeland or recruit foreign-trained specialists to address manpower shortages.
An existential threat looms bigger than nationalistic aspects. Without a unique selling proposition of NHS employment, UK royal colleges may downscale their international presence.
Ironically, RCSEd’s international office, which moved from Kuala Lumpur to the same facility as the Academy of Medicine of Malaysia in Putrajaya, opened less than a year ago in August 2025.
Despite the royal college’s commitment to the cardiothoracic surgery parallel pathway, it’s unclear whether it can attract the same number of trainees as in the past, especially now that it has openly categorised the programme as a “Malaysian” qualification.
Hence, planning a phase-out of parallel pathway programmes with UK royal colleges now, while expanding local Master’s programmes, is a proactive measure, rather than only taking action when trainees are hit by potential closures decided by business entities.
Expand Master’s Clinical Programmes To Private Universities And Hospitals
An MOH doctor with interest in medical education made a novel suggestion of expanding local Master’s clinical programmes to private universities and hospitals.
He noted the existence of private medical universities outside the Klang Valley, such as Kedah and Pahang.
Public universities offering specialist qualifications in medicine, for example Universiti Kebangsaan Malaysia (UKM) located in Kuala Lumpur, can deploy their lecturers to AIMST University so that students can take classes at the latter’s Sungai Petani campus, but receive a postgraduate degree from UKM.
“Instead of 50 people coming to KL, one person goes there and trains,” he told me on condition of anonymity because civil servants are prohibited from speaking to the press.
This would also enable senior consultants in private hospitals to teach at private medical universities, since it’s more difficult for them to enter a Master’s programme as lecturers at a public university.
The MOH doctor further suggested tying private medical universities to private hospitals for specialist training.
A university must be attached to a hospital to run a Master’s clinical programme, as per Malaysian Qualifications Agency (MQA) rules, but most private medical universities do not have their own hospitals.
“Penang Medical College (now known as RUMC) can tie up with Pantai Hospital Penang, for example, and utilise the premises there for Master’s training,” he suggested.
“This will give an opportunity to all the senior consultants working in Pantai to become lecturers and train other people. This means utilising experienced people and our ageing society. We have ageing doctors who are still able to contribute; they can actually be lecturers as part of this programme.”
There is already precedence for this because the cardiothoracic surgery parallel pathway and Universiti Teknologi MARA’s (UiTM) cardiothoracic surgery postgraduate programme both use the National Heart Institute (IJN), legally a private hospital under the Private Healthcare Facilities and Services Act 1998, as a training centre.
I think the MOH doctor’s idea is an excellent use of the huge pool of consultants in the private sector for national service. While private hospitals may not be suitable for housemanship, various specialty strengths in different private hospitals can be used for specialist training.
Although some clinicians in the MOH may be good trainers in the parallel pathway, they should focus on service provision, especially since the public health care system is severely understaffed. The public sector currently has a shortage of some 11,000 specialists.
Leave medical training to universities. MOH doctors shouldn’t take offence at this suggestion; when human resources are scarce, allocation is necessary.
If the government could prepare the Medical amendment bill in less than four months, then it shouldn’t have problems making the necessary regulatory changes within the next few months to enable private universities and hospitals to run Master’s clinical programmes.
This would be a signature reform by the Madani government, marking a huge investment in Malaysia’s local capacity and the future of medical training, compared to the objectives of the foreign-leaning Medical Act amendment that have now been crippled by the UK.
I believe Malaysia has sufficient talent and expertise to run our own programmes. With capricious policy changes by governments in an unpredictable world, we must reduce our reliance on foreign institutions to educate our own citizens, especially for something as critical as medicine.
Boo Su-Lyn is co-founder and editor-in-chief of CodeBlue.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.