Radiologist Careers In Malaysia Health And Social Care Essay

Careers in radiology are amongst the most varied in medicine. Radiologists can opt to be general, providing a comprehensive service to all clinical specialties, or super specialist, becoming highly skilled single field. Most jobs offer both elements, with general radiology and the opportunity to develop and continue a subspecialty interest. Radiologists may also choose to have as much, or as little direct patient contact as they desire. Sessions in fluoroscopy, ultrasound and interventional radiology involve close contact with patients, retaining the motivation that led many doctors to enter medicine in the first place.

Radiology also provides many opportunities for research and teaching. The ongoing technological development in modalities such as magnetic resonance imaging, computed tomography and ultrasound, opens ever new areas to radiological interpretation. These rapidly expanding fields hold great prospect for those with an academic interest.

This resource has been developed by Dr Rhidan Bramley and Dr Hans-Ulrich Laasch © 2001

2.0 WHAT IS MEDICINE?

Medicine is the science and art (ars medicina) of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Before scientific medicine, healing arts were practised in accordance with alchemical treatments and ritual practices that developed out of religious and cultural traditions. The term “Western medicine” was until recently used to refer to scientific and science-based practices to distinguish it from “Eastern medicine” – which are typically based in traditional, anecdotal, or otherwise non-scientific practices.

Contemporary medicine applies health science, biomedical research, and medical technology to diagnose and treat injury and disease, typically through medication, surgery, or some other form of therapy. The word medicine is derived from the Latin ars medicina, meaning the art of healing.

This definition has been quoted from Wikipedia, the free encyclopedia.

3.0 WHO IS A DOCTOR?

A doctor is a medical practitioner, he/she practices medicine. The main role of a medical doctor is to restore and maintain human health. This is done through studying any disease or injury, and applying an appropriate diagnosis and treatment to the patients.

There are many kinds of doctors. Family and general practitioners are usually the first doctors that people will approach when they are not feeling well or sick. These doctors treat common illness such as flu, fever, coughing, stomachache and so on. If the illness is not common, they will refer patients to other doctors, called specialists. Specialists are experts in specific types of health problems.

For example, Gynaecologists dealing with the health of the female reproductive system (uterus, vagina, and ovaries). Internists focus on problems with internal organs. Paediatricians care for children and babies. Surgeons perform operations, like fixing broken bones or transplanting organs. Radiologists are physicians that utilize an array of imaging technologies to diagnose or treat diseases.

Most doctors are doctors of medicine (M.D.). They treat all kinds of diseases and injuries. Some doctors are doctors of osteopathic medicine (D.O.). They focus on muscles and bones.

4.0 WHO IS A RADIOLOGIST?

A radiologist is a physician who has specialized training in obtaining and interpreting medical images, which makes him or her an imaging expert. These images are obtained by using x-rays (radiographs, CT, fluoroscopy), or radioactive substances (nuclear medicine), others by means of sound waves (ultrasound) or the body’s natural magnetism (MRI).

Nearly all physicians examine patients, obtain medical histories, diagnose illnesses, or prescribe and administer treatment for people suffering from injury or disease. According to American Medical Association statistics, 1.2 percent of those physicians specialize in radiology. A radiologist correlates medical image findings with other examinations and tests, recommends further examinations or treatments, and confers with referring physicians (the doctors who send patients to the radiology department or clinic for testing). Radiologists also treat diseases by means of radiation (radiation oncology or nuclear medicine) or minimally invasive, image-guided surgery (interventional radiology).

Like other physicians, a radiologist must have graduated from an accredited medical school and has earned an MD degree. He or she have passed a licensing examination, performed a year of internship, and completed at least four years of graduate medical education (residency) in radiology. Upon completing a residency, these doctors may choose to enter a fellowship program and sub-specialize into one or more areas of radiology.

Radiologists are usually board certified, that is, have taken and passed an examination and thus approved to practice in the field by either the American Board of Radiology (for a medical doctor) or the American Osteopathic Board of Radiology (for an osteopathic doctor).

5.0 WHAT DO RADIOLOGISTS DO?

Acting as an expert consultant to your referring physician (the doctor who sent you to the radiology department or clinic for testing) by aiding him or her in choosing the proper examination, interpreting the resulting medical images, and in using test results in your care.

Treating diseases by means of radiation (radiation oncology) or minimally invasive, image-guided surgery (interventional radiology).

Correlating medical image findings with other examinations and tests.

Recommending further appropriate examinations or treatments when necessary, and conferring with referring physicians.

Directing radiology technologists (personnel who operate the equipment) in the proper performance of quality exams.

A radiologist, through extensive clinical work and related research, may also specialize in one or more radiology subspecialties.

6.0 GENERAL PATH TO PURSUE RADIOLOGIST FOR LOCAL STUDIES

Science Stream in Form 6

Apply medical in local university – 5 years

Housemanship – 2 years

Junior Medical Officer (JMO) – 2 years

Apply for Master in Radiologist in USM, UM or UKM

Go for interview (minimumly 6 months JMO in radiology department)

Study master for 4 years. 1st and 3rd year got exam. 4th year purely assessment.

Radiologist in Malaysia

Radiologist in Malaysia

Get recommendation letter from head of department

Go for interview

Study for FRCR from UK

Part A – to pass 6 papers (no duration limitation and can retake as many times as you can)

Part B – after complete Part A then go for Part B

Fellowship Royal College Radiologist recognition

7.0 PATH TO PROCEED FOR FELLOWSHIP ROYAL COLLEGE RADIOLOGIST

8.0 GENERAL PATH TO PURSUE RADIOLOGIST FOR OVERSEA STUDIES (UK)

Medical School

V

V

V

Radiology attachment / elective

V

V

Pre-registration House Officer

V

V

V

Radiology project / audit

V

V

Senior House Officer in any Clinical Specialty

V

V

V

Further clinical training

Minimum one year

V

V

Postgraduate degree (e.g. MRCP)

V

V

Specialist Registrar in Radiology

Year 1: Basic Sciences

Anatomy

Physics

Radiology technique

Exam FRCR 1

Radiation protection

V

Year 2 & 3: General Training

Plain film radiography

Nuclear medicine

Contrast examinations

Mcq exam FRCR 2a

Ultrasound

Barium procedures

Clinical exam FRCR 2b

CT & MR

V

Year 4 & 5: Subspecialty training

GI-radiology

Cross-sectional imaging

O&G radiology

Uroradiology

Paediatric radiology

General radiology

Mammography

Nuclear medicine

Vascular radiology

Trauma radiology

Neuroradiology

Oncological radiology

Antenatal diagnostic

Chest radiology

ENT / dental radiology

Non-vascular intervention

Musculoskeletal radiology

V

V

V

Year 6: Extended Subspecialty Training

V

Interventional radiology

Vascular radiology

V

Radionuclide imaging

Neuroradiology

V

V

CCST (Certificate of Completion of Specialist Training)

9.0 MINIMUM REQUIREMENTS FOR MALAYSIAN STUDENTS SEEKING TO ENTER MASTER OF MEDICAL IN RADIOLOGY

To be able to apply for Master of Medical in Radiology, one must obtain MBBS in Degree of Medical College in Malaysia.

The minimum requirements for students to pursue Medicine are at least a CGPA of 3.00. However, the Ministry of Education Malaysia has the right to amend the minimum qualification requirements whenever necessary.

Being MBBS honor holder and wishing to proceed to be a radiologist, one must have at least 6 months experience as Junior Medical Officer (JMO) in radiology department during his training. With this condition fulfilled, he/she can then request to seek recommendation from the department head. With the recommendation letter, he/she is able to apply and attend for interview.

Sample interview questions are as below:

Why choose a career in radiology?

Why have you decided to change from your previous career path?

How has your training so far prepared you for a career in radiology?

What do you bring to radiology?

Why have you chosen this training scheme?

What branch of radiology are you interested in?

What are the qualities of a good radiologist?

Have you got a good idea what a radiologist does?

Where do you think radiology is going in the next 5 years?

Should there be 24hr / 7day a week radiology?

Name 2 good and 2 bad aspects about yourself?

Who should radiologists teach?

Does radiology need research?

Do you agree with radiographers having an extended role?

(usually asked by a radiographer)

10.0 TRAINING AND WORKING AS A RADIOLOGIST

Before one become radiologist, one have to attend 4 years of training after obtain his/her degree in medical. The first 2 years is to attend housemanship in Malaysia. The next 2 years is to work as Junior Medical Officer (JMO) in local hospital.

To register for housemanship in Malaysia, these are the requirements and procedures.

10.1 Application for Provisional Registration

Applicants need to submit the following documents:

Form 4 of the Medical Act 1971 for Provisional Registration application form;

2 passport size photos;

A Certified copy of Basic Medical Degree

A Certified copy of your transcript encompassing the results of whole training period

A Certified copy of ‘Bonafide Student Certificate’ – Applicable only to graduates from India, Pakistan and Bangladesh

A Certified copy of Identity Card or passport;

A Certified copy of birth certificate;

A Certified copy of SPM/MCE or equivalent;

A RM20 processing fee by money/postal order payable to The Registrar Medical Practitioner

Apart from the documents above, the following documents need to be submitted:

Local graduates:

The original Dean’s letter

Overseas graduates:

For graduates from Indian institutions – A Certified copy of Bonafide Student and Rotating Internship;

For graduates from Indonesian institutions – A Certified copy of Sarjana Kedokteran and Ijazah Kedokteran;

10.2 Application for Full Registration For Medical Practitioners Undergoing Housemanship In Malaysia

The application should be submitted through the hospital where the applicant has undergone the housemanship training;

The following documents must be submitted:

Form 6 of the Medical Act 1971 to be completed by the hospital;

Form 9 of the Medical Act 1971 to be completed by the applicant (medical officer);

Appendix A form to be completed by the applicant (medical officer);

Form A need to be completed by the respective discipline supervisors where the housemanship was conducted (including extension letters, if applicable);

Certified true copy of the original basic medical degree;

Depending on the status of the documentation, the Council will issue either an acknowledgement or query letter within one weeks of the receipt of the application;

Every application must be sent within one month after the practioner finish their housemanship.

10.3 Full Registration For Medical Practitioners Undergoing Housemanship Overseas

For Malaysians – application can be submitted directly to the Council;

For Non-Malaysians – The application need to be submitted through prospective employer;

The Council’s Evaluation Committee which meets once a month will deliberate ALL application.

The application submitted need to be completed with the following documents (preferably type-written):

Form 9 of the Medical Act for full registration application;

Curriculum Vitae Form (CV);

2 passport sized photographs

A Certified copy of Basic Medical Degree;

A Certified copy of transcript encompassing the whole training period;

A Certified copy of ‘Bonafide Student Certificate’ – Applicable only to graduates from India, Pakistan and Bangladesh;

A Certified copy of Postgraduate Medical Degree, if applicable;

A Certified copies of certificates/confirmation letters of housemanship

A Certified certificates/letters from the hospital or respective Council which confirms the disciplines and the duration of each posting the applicant had undergone during the housemanship training;

A Certified copy/ies of Letter/Testimonials of previous medical experience (For those who had practised overseas after completing housemanship);

A Certified copy of Full Registration Certificate with the Medical Council he is currently registered;

An Original Certificate or Letter of Good Standing from the Medical Council he is currently registered. (Note : Any ‘Letter of Good Standing’ obtained from an institution or an individual will not be entertained.)

A Certified copy of Identity Card or passport;

A RM100 processing fee by money/postal order payable to The Registrar Medical Practitioner;

10.4 Application for Temporary Registration

Application should be made through a practitioner registered with the Malaysian Medical Council with valid and current Annual Practising Certificate who shall be the guarantor; The guarantor shall supervise the practice of the doctor whom the Temporary Practising Certificate is issued to;

All applications must be accompanied by a list of documents stated below: Application will be deliberated by the Evaluation Committee;

Application form for Temporary Practising Certificate (to be type written)

Curriculum Vitae of the applicant (to be type written)

A Certified true copy of basic medical degree.

A Certified true copy of post graduate degree(s)

A Certified true copy of full registration certificate from Medical Council or Medical Licensing Authority of the country of practice.

Current and original Letter of Good Standing from Medical Council or Medical Licensing Authority of the country of practice.

A Certified true copy of testimonials of working experience from Head of Department/ supervisor concerned;

A Certified true copy of Passport (in A4 size paper).

A Certified true copy of Medical Indemnity.

The guarantor will be notified in writing on the Evaluation Committee’s decision; Please ensure that your application is submitted at least 6 (six) weeks prior to date of commencing practice as the Evaluation Committee sits only once a month.

Application must be tendered in 12 (TWELVE) copies.

(NOTE: Only one set needs to be certified true copy in original form). The processing fee for each application is RM50 (Fifty Ringgit), payable in the form of Postal /Money Order to The Registrar of Medical Practitioners.

Note:

Unless printed in either Bahasa Malaysia or English, documents in any other languages need to be translated by a relevant authority into either Bahasa Malaysia or English;

Please download relevant application form and a checklist of documents you must provide in order for your application to be processed;

When we receive your application we will check all your documents and any other evidence that you submit. We may independently verify some documents at their source

It is emphasized that satisfaction of the criteria for registration does not mean automatic approval for registration. Each application will be considered on its own merits.

Application and relevant documents to be submitted to:

The Secretary,

Malaysian Medical Council

Level 2, Block E1, Parcel E, Precinct 1,

Federal Government Administrative Centre

62590 Putrajaya.

Application procedures above taken from Malaysian Medical Council website, which is http://www.mmc.gov.my/v1/

10.5 FIELD OF RADIOLOGY

Breast imaging

The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of breast diseases and conditions. This includes mammography, breast ultrasound, breast MRI, and breast procedures such as breast biopsy.

Cardiovascular Radiology

The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of diseases of the heart and blood vessels (including the arteries and veins, and the lymphatics). This includes x-rays, CT (computed tomography or CAT), ultrasound and MRI.

Chest Radiology

The subspecialty of radiology devoted to diagnostic imaging and diagnosis of diseases of the chest, especially the heart and lungs. This includes x-rays, CT (computed tomography or CAT), Ultrasound, MRI and chest procedures, such as lung biopsy and drainage of fluid from the chest.

Emergency Radiology

The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of trauma and non-traumatic emergency conditions. This includes x-rays, CT (computed tomography or CAT), Ultrasound and MRI.

Gastrointestinal (GI) Radiology

The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of the gastrointestinal (GI), or digestive tract (the stomach and intestines) and abdomen. This includes fluoroscopy, x-rays, CT (computed tomography or CAT), Ultrasound, MRI, and GI procedures such as biopsy, fluid and abscess drainage.

Genitourinary Radiology

The subspecialty of radiology devoted to the diagnosis and treatment of the organs of the reproductive and urinary tracts. This includes x-rays, CT (computed tomography or CAT), MRI and procedures such as biopsy, kidney stone removal, and uterine fibroid removal.

Head and Neck Radiology

The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of diseases of the head and neck. This includes x-rays, CT (computed tomography or CAT), Ultrasound and MRI.

Musculoskeletal Radiology

The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of the muscles and the skeleton. This includes x-rays, CT (computed tomography or CAT), Ultrasound and MRI.

Neuroradiology

The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of the brain and nerves, head, neck and spine. This includes x-rays, CT (computed tomography or CAT), Ultrasound and MRI.

Pediatric Radiology

The subspecialty of radiology devoted to the diagnostic imaging and diagnosis of diseases of children. This includes x-rays, CT (computed tomography or CAT), Ultrasound, MRI and procedures such as fluoroscopy, biopsy and drainage of fluid or abscess collections.

Interventional Radiology

The subspecialty of radiology devoted to the imaging, diagnosis and treatment of patients utilizing minimally invasive interventional techniques. This includes imaging and treatment of the blood vessels (such as angiography, angioplasty and stent placement), biopsy procedures, line and tube placement, uterine fibroid removal, fluid and abscess drainage, These can be performed with x-rays, fluoroscopy, CT (computed tomography or CAT), Ultrasound or MRI.

Nuclear Radiology

The subspecialty of radiology devoted to the imaging, diagnosis and treatment of patients with trace doses of radioactive material. This includes imaging of the heart, the skeletal system, and most organs in the body (for example the thyroid and parathyroid glands, liver, spleen, kidneys, lungs, etc). It also includes the treatment of various conditions in the body such as a hyperactive thyroid gland and thyroid cancer. The imaging modalities include a gamma imaging, PET, and PET/CT.

Radiation Oncology

The subspecialty of radiology devoted to the treatment of cancer with radiation. The radiation may be delivered from an outside x-ray source or may be injected into the body.

10.6 TERMS USED FOR SERVICES/RANGE OF FACILITIES

Services / facilities

Description

Plain X-rays

Refers to plain radiographs such as Chest X-rays, spine x-rays

Fluoroscopic Services

Includes gastrointestinal barium studies such as barium meal, enema, Barium swallow; study of the lower limb veins

Ultrasound

Basic refers to plain ultrasound (grey scale) while duplex or Doppler ultrasound refers to ultrasound which includes those able to image vessels and blood flow/

Mammography

Plain refers to basic mammography. Other facilities to perform procedures under mammographic guidance include ductography (imaging of the ducts of the breasts), Stereotaxic facility (which enables needle biopsy procedures using computerized aid), hookwire localization with compression plate method is the localization of a lesion that cannot be felt with the hands using the 2 view perforated compression plate technique.

CT Scan

This refers to computerized axial tomography. This ranges from the basic non-spiral, spiral to multislice technologies. Multislice scanners are the latest in the market. The Electron Beam CT (EBCT) is an ultra fast scanner whose forte is in CT scan of the heart for coronary artery calcification and CT Angiography of the heart.  The latest Multislice fast scanners are now capable of CT of the coronary arteries as well.

The “abilities” of the scanners differ according to type. Special scans include those capable of CT Scan for coronary Artery calcification, Special CT examination of the blood vessels (CT Angiography), CT Perfusion and quantitative CT Densitometry (for bone density quantification)

Magnetic Resonance Imaging (MRI)

Refers to imaging using magnetic fields. Again, there are different types and they may be an open magnet, a permanent magnet of a superconducting magnet. Additional special features are sometimes due to additional software and hardware. These include kinematic MR for joints, Magnetic Resonance Angiography (MRA), Contrast Enhanced MRA, Diffusion, Perfusion techniques, Functional MRI and spectroscopy.

Angiogram

The study of blood vessels under special fluoroscopic guidance and is usually using digital subtraction techniques.

Interventional Facilities

Ranges from the basic to special interventional procedures that require further training. They include neurointervention, peripheral vascular intervention, chemoembolisation, RF ablation, Ethanol Ablation, Vertebroplasty, Uterine fibroid embolisation.

Bone densitometry

Refers to the measurement of bone density and this can done either by X-ray (Dual Energy Bone densitometry – DEXA), ultrasound or quantitative CT.

10.7 EXAMPLES OF SCANNING IMAGES

11.0 WHERE TO STUDY RADIOLOGIST IN MALAYSIA UNIVERSITY

University Malaya

Address: University of Malaya, 50603 Kuala Lumpur, MALAYSIA

Tel : +603-7967 7022/3273

Fax : +603-7956 0027

Email : icr@um.edu.my

International Undergraduate Enquiries : isc@um.edu.my

Postgraduate Enquiries : ips@um.edu.my

Universiti Sains Malaysia

Address: Universiti Sains Malaysia, 11800, Pulau Pinang Malaysia

Tel : +604-653 3888 

Fax : +604-658 9666

Emel : pro@notes.usm.my

Universiti Kebangsaan Malaysia

Address: Universiti Kebangsaan Malaysia, 43600 UKM, Bangi Selangor, Malaysia 

Tel : +603 8921 5555 

Fax : +603 8921 5555 

E-mail : webmaster@ukm.my