Since I started studying Medicine in 2014, I kept being asked this question "What do you want to specialise in?" I had always found it a difficult question to answer. As a matter of fact, I found every specialty interesting in its own way. Choosing a particular specialty would mean that I would be out of touch with the other specialties. It would be quite boring if I could only do one specialty.
I was also told "Don't be a GP (General Practitioner). There's already too many GPs in our country, it's useless to become one. You should become a specialist instead." I never agreed with that statement. I firmly believed that as long as you genuinely want to contribute to the society, all doctors including GPs and specialists play a very important and noble role.
In fact, I found the job of GPs really great from my observations. General Practice is very broad. Being the first point of contact for patients, GPs get to see cases of all specialties. This is certainly more interesting than doing a specific specialty. I also value work-life balance very much. GPs certainly have much better work-life balance with more manageable workload and working hours compared to doctors in hospital-based practice.
In 2017, I finally understood that General Practice is actually a specialty on its own, which is also known as Family Medicine. We can specialise in General Practice, and I started considering it. I was aware that it's extremely competitive to get into a Master's programme for Family Medicine at public universities in Malaysia. Therefore, I thought of taking the Membership of the Royal College of General Practitioners (MRCGP) exam instead.
Throughout Year 3 to Year 5 of MBBS, I performed particularly well in the General Practice rotation compared to other hospital-based rotations. I also found myself learning much more efficiently in General Practice settings compared to hospital settings. During my Electives in Year 4 of MBBS, I chose to do General Practice. Meanwhile, many of my friends had little interest in General Practice.
In 2019, I realised that GPs have to regularly follow up patients with chronic conditions. I didn't have much interest in that, due to my style of studying Medicine which places huge emphasis on managing acute conditions and acute presentations of chronic conditions. During the End of Stage MOSLER for Year 5 of MBBS that year, there were several follow up cases for chronic conditions. I performed poorly in those cases and ended up failing the MOSLER and having to repeat Year 5.
I also found out that the MRCGP exam can only be taken as part of a General Practice specialty training programme in UK; it cannot be taken in Malaysia. Consequently, my interest in General Practice waned and I had a change of plan. I decided to take the Membership of the Royal Colleges of Physicians (MRCP) exam and pursue Internal Medicine instead. Just like General Practice, Internal Medicine is very broad and encompasses many specialties. Unlike MRCGP, the MRCP can be taken in Malaysia as a standalone qualification.
After I started House Officer training at Kluang hospital in 2021, I found out a harsh reality that Medical Officers (MO) and specialists in hospital-based practice in Malaysia have to routinely work continuous 33-hour on-calls lasting from 8AM till 5PM on the next day. Just imagine how tiring and stressful it is! As a result, I decided I most definitely don't want to do hospital-based practice, including Internal Medicine. That leaves General Practice as the only viable clinical specialty for me.
In October 2022, I discovered that the RCSI-UCD Malaysia Campus (RUMC) offers a General Practice specialty training programme known as the Malaysia-Ireland Training for Family Medicine (MInTFM), which incorporates the Membership of the Irish College of General Practitioners (MICGP) exam. This provides an alternative route for joining General Practice specialty training in Malaysia apart from the very competitive Master's programmes at public universities.
I was once again interested to specialise in General Practice and I seriously considered joining RUMC's MInTFM programme. Later in 2023, I found out that we are only allowed to join the MInTFM under the Ministry of Health's Hadiah Latihan Persekutuan (HLP) scheme; self funding is not allowed. Only MOs working with the Ministry of Health are eligible for the HLP.
After completing House Officer training in January 2024, I worked as a MO in Internal Medicine at Kluang hospital. Although I had a high degree of theoretical interest in Internal Medicine, the 33-hour on-calls and heavy workload were totally unbearable for me. I desperately wanted out of it, hoping to move to a General Practice setting or to become a Medical Lecturer instead.
In June 2024, I got transferred to Klinik Kesihatan Sundar in Sarawak. That was my first time working in a General Practice setting. Sundar is a very secluded village. Although the work there was quite fun and relaxing, I was deeply troubled by the extreme isolation and difficult life at that place. I couldn't enjoy the job and I was constantly stressed and frustrated. I applied for Medical Lecturer posts at multiple universities, but all were unsuccessful.
Eventually in October 2024, I was transferred to Klinik Kesihatan Ibu dan Anak (KKIA) Limbang, another General Practice setting. KKIA Limbang is a total paradise, with supportive work environment, manageable workload and no on-calls, in the nice town of Limbang. I enjoy my work there so much and I make sure to show my fullest enthusiasm and dedication in my work. I always put in my time and efforts to communicate properly with every patient to address their concerns and expectations. I also realised that following up patients with chronic conditions is actually quite interesting.
I finally understood that General Practice is my true calling and I want to keep doing it in the future. With that, I set my minds on applying for RUMC's MInTFM programme. After my application was shortlisted, I took the Clinical Entrance Test on 21 January 2025 and attended the interview on 20 February 2025. On 26 February 2025, I was informed by RUMC that I was successful in the application. However, I may only join the MInTFM in July 2026, due to the fact that I am only eligible to apply for the HLP in the following year.
It marks a very significant milestone in my life, as this is my first time receiving an offer for a specialty training programme, even with the delayed start. I will still go ahead with completing the MRCP, as it too is very valuable for GPs. I look forward to my future career in General Practice (Family Medicine).
