Tuesday, May 25, 2010
I've been getting about 4 hours of sleep on weekdays for the past few weeks. Things are really starting to pick up and I am really getting a feel of what I'll need to do as a doctor. Although medicine can be really simple and straightforward in practice, getting a grip of it requires alot of mental connections and associations to be made. I feel guilty for missing clinical learning opportunities and that is why I will try to make it even if it means waking up 4 hours after going to bed.
In this post I talk about My Story. Why I sometimes feel guilty and how I ended up as an international medical student. I also discuss the answers to some questions I get asked all the time. I am writing this as I feel many Malaysians do not know the real situation abroad, especially with regards to government policy on international medical scholarships (it's less racially biased than you think!). Next is a hypothesis why 16 straight A's will not necessarily secure you a scholarship in medicine. Finally, I will talk about what I think is important for a highschool student thinking of applying for a scholarship in medicine: Tips For Securing A Medical Scholarship And Getting Into Medschool.
Why feel guilty? It's simple really. It boils down to mathematics. There are 52 weeks in a year. Take away two months for all the holidays and breaks and you are left with 44 weeks. There are 5 working days in a week. That means there are about 220 days of clinical learning opportunities in a year. Medicine is an exorbitantly expensive course. That's why my parents sneakily promised me a car if I received a scholarship for medicine. I studied my arse off during Form 5 (Year 11) and college. The cost of a car pales in comparison to the tuition fees. This year, tuition fees hit a new high: $46,000 (RM138,000). There is no way in hell I would be studying medicine in Australia without support - my family simply cannot afford it. I would have probably been to a local university for less than a third of the cost.
$46,000 divided by 220 days works out to $210/day. Yup. That's how precious every day of clinical learning is. Heck I complain about my rent ($700/month), when skipping just four days of clinical learning (clinics/ward rounds/theater/seminars) wastes more money than my rent! It is totally absurd.
I saw a report in TheStar (a Malaysian daily) about some plantation workers complaining about their wages that have stagnated in recent decades. They get about $200/RM600 a MONTH for back breaking hard labour. Their employers then deduct rent and utilities, and many are left with only RM400 for their family. That's how absurd a $210/day tuition fee is. And that is why I cannot skip clinical learning opportunities.
So Why Does The Malaysian Government Do This?
Again, the answer is simple. Malaysia is critically short of specialized medical professionals. To put things into perspective, there are only THREE. yes, three, haem-oncologists (blood cancer specialists) in the entire country of 25,000,000+ people. Even with private and public practicing specialists combined, malaysia is still gravely short of specialists in most important fields. Malaysia really needs specialists, and even if students have to return after a few years, the degrees that they hold will enable them to pursue their specialties in world renowned centers around the globe. They would also absorb the working culture in hospitals around the world.
Ideally, I would like to do my internship in Australia and pursue specialization. I have no long term plans to stay in Australia. There are many reasons for this but my main reason is that my parents are back home. I also just dont feel "at home" in Australia for some reason. It's hard to explain... It has to do with culture and upbringing I presume - the way I interact is different from the way the locals interact. Im not saying we dont get along. We do actually, quite well... and I mix freely with the locals from the Halls especially, but in the end it's hard to 'click' in the same way you could 'click' with a fellow Malaysian. It's like a different mindset. Different culture. Different upbringing. And I have not even started talking about the food. Im sick of Subway and McDonalds. Shops close so damn early here and mamaks dont exist. Yeah it's a lifestyle thing. And let's not forget about the 47% income tax in Australia, compared to 27% in Malaysia. Once things like housing and cost of living is factored in, a specialist would live just as comfortably in Malaysia as Australia.
Politics & Dissent
Malaysia has had a rather unique history. Chinese people lived in cities, Malay people lived in rice fields and villages, while Indians lived in plantations. Traditionally, the land was governed by Malay rulers (sultans and raja's). The British put into place many of the children of the Malay aristocracy into power before Malaysia was given independence. So we had lots of reasonably well off Chinese people in towns, and massive amounts of poor Malay people in rural villages.
Unsurprisingly, the Malay aristocracy that took over after independence ensured that racial affirmative policies written in it's constitution. Essentially, the government works to uplift the Malay people via affirmative action. Other races receive government support as well, but to a much lesser extent. It appears that "malay" is not technically a race per se (defined by genetics). It seems to be a nationality as defined by the constitution. The best example of this is the former prime minister Tun Dr Mahatir who's father was from India. He is also one of the strongest proponents of racial affirmative policies in the malaysian political landscape. No one can argue that the Malaysian government has succeeded in creating a burgeoning Malay middle class (many of my friends from Malaysia are from this group of people!), but there is an understandable amount of frustration among the non-malay community.
You could see how such an exorbitantly expensive course handed out to students under a public system can cause alot of discontent among Malaysians especially if it is perceived that racial affirmative polices were used at the expense of meritocracy. Every year without fail, there will be the story of some Chinese or Indian student who passes Form 5 (Year 12) with flying colours but fails to score a scholarship in Medicine. A typical student takes 9 subjects in Form 5. These students take up to 16 subjects and score straight "A"s. Understandably, there will be uproar from the Chinese and Indian communities accusing the government of discrimination.
Is The Malaysian Government Really Being Unfair?
I cannot speak for the local Malaysian education scene, but for the Medical course at Monash University (Melbourne) at least, the proportion of Chinese, Indian and Malay scholarship holders seems to be roughly the same as the proportion of those races in Malaysia. Sure, different races tend to get in under different public institutions, but in the end there seems to be an equal number of Malay and Chinese scholarship holders with a few Indian scholarship holders here and there. This represents the demography of Malaysia quite well. Dare I say that even the proportion of Indians to Indian Sikhs match the demography of Malaysia. Ok the sample size for the Indian vs Sikhs comparison isnt big enough (n=4) but you get the idea.
What Happened To The 13, 14, 15, 16 straight "A" students?
(This Is Only A Hypothesis Based On Rumour)
It is a myth that the more "A"s you score in Form 5, the more likely you are to get a scholarship. There are a multitude of subjects offered, from painting to baking and rotisserie (no kidding!). What's important is that you need to score in the major science subjects: Additional Maths, Chemistry, and Physics. There are many Chinese and Indian scholars with 10A's who got the scholarship! They seem to have one thing in common - they are all very comfortable with the major science subjects. Having 16 "A"s wont really mean anything if you dont have a high "A" (in percentiles) in those subjects. Im not talking about "1A"s here. I am talking about the actual percentile score, or how well you did compared to other students. It is rumoured that government sponsors filter candidates by their percentile scores for those subjects, with a little consideration for people from remote areas.
How Did I Get Selected?
Honestly, I have no real idea. I was not expecting to get selected for the scholarship. I had already started an A-levels program when I got the news that I was accepted. Before I got the scholarship, I too had taught that straight 1As were required for it.
I had one flaw in my results, a 2A for - of all subjects - Biology. Now in fourth year of medicine I realize how irrelevant that subject is to medicine but back then I taught it eliminated all hope of getting selected for the interview.
Rumour has it that once a person gets straight A's, sponsorship organizations will look at the major science subjects and your percentile score. 1A's will not help you in Add Maths, Chemistry and Physics. Scoring higher than 99% of other students in those subjects would. (I made up the 99% figure for illustration. I dont know the actual cut off). From that smaller pool of candidates they will then select who gets accepted for the interview by looking at your CV.
Now I dont mean to blow my own horn, but if CV's were ever in a beauty pageant, mine would have been Jessica Alba before she got pregnant. By coincidence been very very active in Form 4 and Form 5. I lost count of the number of debates and elocution contests (public speaking) I represented my school in. I also represented my school for ping-pong. As luck would have it, I was one of the few people who turned up for the first meeting of the Red Crescent society and by dumb luck I held a post in the society. I was also a prefect throughout Form 2-5 and held various posts. The thing is, I had certificates to back every thing up! I know alot of people complain about government schools, but my experience in SMK Sultan Salahuddin Abdul Aziz Shah was great. The teachers (almost all Malay) were very supportive and encouraging. You can say all you want about how government schools suck, but at the end of the day, if you approach your teachers with sincere dignity and respect they will teach you in earnst. They promoted co-curricular activities till the cows came home. Apparently there was an incentive program for them to do that but regardless I am very grateful I had switched from a private school to a public one. My Malay language teacher was also really awesome, and I had scored 1A for Malay, a feat I would have not been able to dream of should I have continued schooling at a private school. I was the top student in Physics and was third runner up in my Form 5 cohort (Thanks to 2A Biology...bah). Academic performance TICK. Academic co-curricular activities TICK. Sports activities TICK. Uniformed Societies (Badan Beruniform) TICK. Jessica Alba...
Getting Into Medical School
After getting the scholarship, I still needed to do a foundation program as the Malaysian Form 5 certificate is not recognized internationally. I did an International Baccalaureate Diploma program similar to A'levels. Note that if you intend to get into Medicine, you may have to choose your subjects appropriately. Believe it or not Biology is not a requirement for most medical schools but Maths and Chemistry are. I did Higher Level Biology, HL Maths (damn @#$%^& matrix integration) and HL Chemistry. You will need high scores in your core science subjects regardless of your score. Requirements vary by country, but as far as placements go, Australia seems pretty tough to get in. Melbourne requires 40 points and above for IB students with no exceptions. Monash is a little more lenient with a 38 point cut off. Many Irish and British universities take students with a minimum of 35 or 36 points. Space in medical school is extremely limited, hence you tend to accept the first offer that comes your way. Monash offered me a place a few months before I got my results and I snapped it up. In the end I scored 40 points with straight 7s for all sciences. With that I was on my way to Australia.
Tips For Securing A Medical Scholarship And Getting A Place In Medschool:
1) In highschool, SCORE/OWN/PWN/DOMINATE for the major science subjects. Additional Maths, Physics and Chemistry. High nineties no excuses. Maximum percentile score possible. Pwn your classmates. Pwn your entire year level.
2) Get straight A's.
3) Take part in different co-curricular activities, and remember to receive a certificate for any activity you participate in! Build your CV!
4) Dont screw up the scholarship interview.
5) Score in whatever foundation program you are doing (above 95th percentile) with good results for the main science subjects.
6) Prepare for the medical school interview. Take the necessary IQ/language/etc tests.
7) Pray... You have done what you can. Once you're in you're in.