Nocturnale

Emergency medicine is a relatively new branch of medical specialty, especially so in Malaysia where the first Master of Medicine program (MMed Emerg Med) started off as recently as 1998 .

Emergency medicine is attractive as an option for specialization for the following reasons :

1. A large variety of presenting complaints from the entire age spectrum.
2. You are the first contact the patient comes across, which means being the first one to work up the patient to come up with a diagnosis.
3. Opportunity to do a number of procedures.
4. Opportunity to function as a real member of the resuscitation teams
5. Opportunity for dwelling into ‘disaster and mass gathering’ medicine
6. Opportunity for focused blocks of shift work.

Malaysia has seen some rapid growth in terms of physician training in the field of emergency medicine with the rising needs of the population for 24-hour acute and urgent care. To date, there are three public universities which offer limited places for their respective four-year MMed (Emerg Med) program, namely:

1. Universiti Sains Malaysia
2. Universiti Kebangsaan Malaysia
3. Universiti Malaya

Competition for admission to the MMed program will only escalate as the popularity of the specialty becomes prevalent. What more with the bloating number of the so-called ‘chronic ER MOs’ finally seeing the light at the end of their collapsing career tunnel in the form of extended training disguised as a master program, the fight for the few places each year will get intense.

Eligibility for local MMed (Emerg Med)

1. Basic medical degree recognized by the Malaysian Medical Council
2. At least 3 years of clinical experience after medical school (this is not fixed and may vary, contrary to what many think. I have been relayed anecdotal evidence that some buggers got into the program with a mere one-year housemanship experience, which showed how well cable-pulling maneuvers still thrive within the local academia.)
3. Passing an interview session with the board of selection committee
4. Certification of integrity and confirmation in current working post (pengesahan dalam jawatan), what is probably the stupidest and most irrelevant prerequisite.

Although working experience in the Emergency Department is not a hard requirement, it is still very much preferable taking into the account the fact that most if not all of the applicants will most likely have ‘camped’ in the ED for at least a year or more. You will be at a glaring disadvantage to not have worked in the ED prior to your application. Worse, it may make you look like some valiant fool, attempting to get into a program of your interest without any evidence of indulgence before this.

Getting Ahead of your Competitions

With so many potential candidates vying for the meager number of Master trainee spots, what can you do to improve your chances? I post this question to my friend who is an Emergency Medicine trainee. He gleefully offered some helpful advice.

1. Make sure you know your stuffs. You will be fired a series of core questions on Emergency Medicine during the interview. Examples: Tell me about rapid sequence intubation; What are the management principles of a patient presenting with diabetic ketoacidosis? Read a book like Handbook on Emergency Medicine cover to cover. Commit a set of core information into memory.
2. Pass your Part 1 – MRCP, MRCS or even MRCPCH. This is perhaps the most reliable evidence of your commitment towards postgraduate studies.
3. Resuscitation medicine is a big thing in Emergency Medicine. Join your hospital resuscitation training team and contribute as an educator. Example: Basic Life Support (BLS) instructor
4. Be productive as a medical officer: Get involved in audit exercises, basic statistical studies, quality improvement measures at your Emergency Department. Make an impression that you actually care about the running of an ED.

Conclusion

The days of emergency physicians gaining respect and recognition are not too far away now that advanced training in emergency medicine is in place to train new doctors. Nonetheless, we all know that no matter how hard the government works to meet the demands for more postgraduate training opportunities, there are bound to be inadequacies in the system.

Authentic, genuinely capable candidates are often neglected and ignored while slothful medical lowlife book themselves into First Year Master without breaking a sweat. Fear not, enter the green pastures on Part II of this article as I explore the various fast-track options for obtaining truly formidable certifications in Emergency Medicine.