CHARACTERISTICS OF THE DOCTORS

45 • • • 5.3 AGE DISTRIB ¹ º ION The age distribution of primary care doctors is shown in Figure 5.3.1. • Most 30.7 of the primary care doctors in Malaysia fell in the age group of 45–54 years, followed by those aged 25–34 years old 25.1. • The vast majority 79.9 of doctors practising in the public sector were within the youngest age group 25–34 years. Only 6.2 of the public doctors were 45 years or older. • In contrast, most 40.2 of the doctors in the private sector were between the ages of 45 and 54, while those aged 25–34 years accounted for only 4.2 of doctors in private practices. • The median age for doctors in public sector was 30 years old IQR: 28–33 years, whereas the private sector was 49 years old IQR: 43–57 years. Figure 5.3.1: Distribution » ¼ public and private doctors by age group in 2014 Note: Missing data excluded from analysis. 5.4 ½ ¾ PERIENCE Figure 5.4.1 presents the distribution of public and private doctors by years of experience in primary care. • Nearly two-thirds 62.0 of the primary care doctors had practised in primary care for 10 years or more. • The vast majority 74.8 of the public sector doctors had less than five years of primary care experience. Conversely, in the private practice, 81.1 of the doctors had more than 10 years of experience in primary care. ¿ ÀÁ 0.3 Â Ã À ¿

5.9 40.2

13.9 26.0

79.9 10 20 30 40 50 60 70 80 90 100 Public Private Ä Å Æ Ç Å È É Ê Ë Ì Ê Ç É Ê Æ Í Î Ï Ð 25–34 years 35–44 years 45–54 years 55–64 years ≥ 65 years 4.2 Chapter 5 : The Doctors 46 National Medical Care Statistics 2014 Figure 5.4.1: Distribution Ñ Ò public and private doctors by years Ñ Ò experience in 2014 Note: Missing data excluded from analysis. These findings were consistent with the age distribution of doctors in the public and private sectors. The public-private differences in age structure and experience could be plausibly attributed to the regulations governing medical practice in Malaysia. Medical graduates are required to fulfil several years of mandatory public service before they are allowed to move to private practice. This could have profound implications for patient care, with a greater burden being placed on senior doctors who remain in the public sector, while the expertise of the more experienced doctors is underutilised in the private sector. 3

5.5 PLACE OF GRAD

Ó ATION Undergraduate medical degrees awarded by 33 local medical schools 11 public and 22 private and 375 accredited foreign medical schools are recognised by the Malaysian Medical Council. 8 Graduates from recognised institutions are eligible for registration to practise medicine in Malaysia, while international medical graduates who hold unrecognised degrees must pass the qualifying examination to be eligible for registration. Figure 5.5.1 shows the distribution of primary care doctors by their place of graduation. • More than half 51.5 of the doctors in primary care obtained their medical degree from a foreign country. • The proportions of locally trained and overseas trained doctors were about the same within and across sectors, with 49.9 of doctors in the public sector and 48.0 of private sector doctors graduated from medical schools in Malaysia. 12.2 Ô Õ Ö Õ 13.0 Õ Õ ÖÔ × Ø ÖÔ 7.1 10 20 30 40 50 60 70 80 90 100 Public Private Ù Ú Û Ü Ú Ý Þ ß à á ß Ü Þ ß Û â ã ä å 5 years 5–9 years ≥ 10 years • • 47 • • ≥ Figure 5.5.1: Distribution o æ public and private doctors by place o æ graduation in 2014 Note: Missing data excluded from analysis.

5.6 POSTGRA

ç è é TE ê è ALIFICATION Primary care doctors may specialise in family medicine via Master of Family Medicine programmes, Membership of the Academy of Family Physicians of Malaysia MAFP, Fellowship of the Royal Australian College of General Practitioners FRACGP, or Membership or Fellowship of the Royal College of General Practitioners MRCGPFRCGP. To qualify as a family medicine specialist in Malaysia, the postgraduate degree must be credentialed by the Ministry of Health. Other postgraduate qualifications include Diploma in Family Medicine, diplomas in occupational health, dermatology, diagnostic ultrasoundradiography, master’s degrees in public health, and Membership of the Royal College of Physicians. Figure 5.6.1 shows the distribution of primary care doctors by postgraduate qualification. • Only 15.7 of the primary care doctors held at least one postgraduate qualification. • A higher proportion of doctors in the private sector held at least one postgraduate qualification compared to the public sector 18.8 versus 7.3, respectively.

50.1 52.0

49.9 ë ì íî 10 20 30 40 50 60 70 80 90 100 Public Private ï ð ñ ò ð ó ô õ ö ÷ õ ò ô õ ñ ø ù ú û Local Foreign Chapter 5 : The Doctors