HISTORY OF GYNAECOLOGY ONCOLOGY TRAINING AND SERVICES IN MALAYSIA
This
article covers the history of gynaecology oncology training and services
involving ministry of health, academic institutions and private sectors. The
list of contributors is long and some names may be missed unintentionally.
ROLE OF MINISTRY OF
HEALTH, ACADEMIC INSTITUTIONS
AND ACADEMIC OF MEDICINE
University
Malaya was probably the first institution that provide gynaecology oncology
services in Malaysia. In 1965, under the leadership of O&G Professor Dr
Donald Chan, the doctors there were already doing operations for gynae cancer
patients and giving chemotherapy. This interest was continued by lecturers like
Doctors WF Chan and KH Ng and subsequently Associate Professor DK Sen. By 1976,
the University’s dedicated Gynae Oncology Unit was planned with 2 doctors being
sent for full training in UK and Europe. They were Prof Emeritus. Dato. Dr.
Sivanesaratnam and Dr. Haji Ahmad Adlan Nuruddin. Numerous other doctors had
since, came along. The other universities (UKM and USM) followed suit in the
early 1980s and 1990s. In UKM the early gynaecologist with special interest in
oncology were Dato Dr Haji Onny Yahya and Dato Dr. Abdul Aziz Yahya. USM had
Associate Professor Dr. Haji Nik Mohd Zaki Nik Mahmood in the later stage.
Professor Emeritus Dato Dr.Sivanesaretnam is the longest serving Gynaecologic
Oncologist who has contributing not only in providing Gynaecology Oncology
services in University Malaya, but also in research and training of many
O&G Specialists in Malaysia.
Prior
to 1996, while the universities were developing their services, there were
already government doctors performing surgery and administering chemotherapy
for selected patients. In the late 1960s and 1970s, one such person was Dr.
(Mrs) Mehra in HKL. Through the years;
other experienced doctors came along in places like HKL and Ipoh General
Hospital . Some of the familiar names will be Dato Dr. Alex Mathews and Dato.
Dr. N. Sivalingam. In 1990; Dato Dr. N. Sivamohan from HKL was awarded
the British Commonwealth Medical Foundation Scholarship for Gynae-Oncology in
the UK. Upon his completion of the 2 years fellowship, he returned to work at
Hospital Kuala Lumpur as Consultant Obstetrician&
Gynaecologist/Gynae-Oncologist. Over in Penang; the role of gynae oncologist
was shouldered by Dr. Suresh Kumarasamy following completion of his training in
the UK in 1995. He continued his contribution in the field of Gynaecology
Oncology in Private Institution in Penang until now.
In
1996, the senior O&G Specialists in Ministry of Health under Jawatankuasa
Pengurusan dan Perkembangan O&G Malaysia (JKPPOG), Ministry of Health under
the leadership of Dato’ Dr. Sivalingam Nalliah begin to initiate an idea and
formulating a structured subspeciality training program in Gynaecology Oncology
for the O&G specialists and consultants in Malaysia. This would allow
proper credentialing and privileging and also place our Malaysian doctors on
par with their international counterparts. In 1998-99, the fellowship training
program for Gynaecology Oncology MOH was started. The subcomittee of
Gynaecology Oncology of JKPPOG was created to coordinate the program and first
chairman of this subcommittee was Dr. Ng Kok Ying. When she retired, the
responsibility was taken over by Dr. Madam Lim Keng Joo. In 2004, the mantle
was passed to Dato Dr. Ghazali Ismail who is also an instrumental in expanding
and improving this training program until today.
The
Gynaecology Oncology sub-specialty committee, JKPPOG consist of 7 selected members;
all seniors, in this field. Three members are consultants from the Health
Ministry, one is from the Academy of Medicine (College of O&G or CHOGAMM)
while the other three represents the 3 major universities (i.e. UM, UKM and
USM).The committee will interview all the aspiring candidates, vet them, and
assist in their training, both locally and outside Malaysia. The committee
members; especially the chairman, will also use their goodwill and contacts to
procure scholarships (JPA) and work opportunities in hospitals all over Asia,
UK and Europe. So far, the candidates had been trained in places such as
Singapore, Thailand, Hong Kong, Taiwan, Japan, Australia and South Africa. Upon
completing 3 years training, the candidates will submit their application for
exit certifications and their application will be vetted by central committee
of JKPPOG before approval and credentialing.
The
first product of Gynaecology Oncology Subspeciality training completed the 3
years training program in 2001. The first returnee from the first batch was Dato
Dr. Mohd Rushdan Md Noor. He went on to set up the Gynae-Oncology Unit in
Hospital Alor Setar, Kedah (now known as Hospital Sultanah Bahiyah) and his
unit became the first designated Government Hospital as an established referral
centre (Northern Region) and training centre for Gynaecology Oncology
Subspeciality MOH. Since then; the numbers of fellows had grown and most major
hospitals now have one or two trained Gynae-oncologists to serve the public.
They have contributed in providing the gynaecology oncology service to patients
from respective state and region. Some of these hospitals are also recognized
as a training centre for Gynaecology Oncology subspeciality training program
such as Hospital Sultanah Bahiyah, Hospital Ampang, Hospital Kuala Lumpur, Women’s
and Children’s Hospital Likas, Hospital Umum Sarawak, Hospital Sultan Ismail, Johor,
, etc. Beside government hospital, Academic Institutions such as UMMC, UKM and
USM are also currently a recognized training centres for this program. At the time
of writing this article, Gynaecology Oncology subspeciality training program,
MOH have recruiting 48 O&G specialists from this country including those
who are still undergoing training. Currently almost all major government
hospital in this country have resident Gynaecologic Oncologists.
ROLE OF O&G SOCIETY
OF MALAYSIA (OGSM) AND
MALAYSIAN GYNAECOLOGIC CANCER SOCIETY (MGCS)
Gynaecology
Oncology services, teaching and training is also contributed by
non-governmental organization such as O&G Society of Malaysia (OGSM) and
Malaysian Gynaecologic Cancer Society. OGSM under Gynaecology Oncology
subcommittee had been involved in various academic and training activities
since this society was registered. The contribution of OGSM is undeniably have
given an opportunity to many doctors to understand more about Gynae Oncology in
order to provide better care to gynae cancer patients. Malaysian Gynaecologic
Cancer Society (MGCS) was registered in 24th April 2011 and it have
been endorsed by International Gynaecologic Cancer Society (IGCS). The first
president of this society was Dato’ Dr. Mohd Rushdan Md Noor. The idea of
having such oganization was first mooted way back in 2005 during the 1st
National Gynaecology Oncology Symposium held in Alor Setar, Kedah. The pioneers
who initiated it were Dato Dr.Mohd Rushdan Md Noor, Dato' Dr.Ghazali Ismail,
Prof. Emeritus Dato Dr.Sivanesaratnam, Prof Dr.Siti Zawiyah, Prof Dr.Nik Mohd
Zaki, Prof Dr.Ahmad Zailani Hatta, Dr.Vijaendrah, Dr.Lim Keng Joo and
Dr.Zaridah Shafie. They sat down and explored the idea to form a society that
has similar role and responsibility with same society in other countries. The
main agenda of this society is to bring together all Gynae Oncologist , both in
the Health Ministry, Academic institutions and also Private Institutions under
one roof with common goal. The initial intention was to have collaborative
group in research but later was expanded to cover more roles including creating
a wide network to facilitate better coordination and
cooperation among all Gynae oncologists not only in Malaysia but also from our
neighboring countries. These in turn help provides better care for gynae cancer
patients. With the support from Ministry of Health, Academic Institutions and O&G
Society of Malaysia, MGCS have involved in various training and CME program
including organizing Gynae Oncology Conferences, workshops, training and public
education. MGCS is also currently involved in preparing the Clinical Practice
Guideline and research projects and the latest is multicenter trial on the role
of HPV DNA testing as primary screening test for cervical cancer.
In
summary, Gynaecology Oncology Services in Malaysia is progressing towards
correct direction and this would not be possible without great contributions,
handwork and cooperation from everyone involved and every single Institutions
either from government, academia and also from non-governmental organizations.
Dr.Zamzida bt Yusoff
Consultant Gynae Oncologist
Consultant Gynae Oncologist
PHOTO GALLERY
