Dr Koh Chong Tuan President
Malaysian Paediatric Association 1999

I would like to clarify the issue raised by Hew Kiang Hoe in his letter "Doctors posing as consultant specialists" (NST, Sept 3). A paediatrician or child specialist is generally regarded as a doctor who has obtained a recognised form of accreditation by a professional college or university.

Traditionally, this would mean passing the examinations conducted by the Royal Colleges in the United Kingdom (or equivalent such as the Australian College or the American Board).

One of the criteria to take these examinations is certified training in the field of child health and diseases for a specified period of time under the supervision of a senior paediatrician. If the candidate fulfills the requirements, then he or she is allowed to take the examinations. Having made it through the examination, most candidates would then return to government service for an additional period of supervision before being gazetted or accredited as a child specialist by the Ministry of Health.

In the last 15 years or so, as local universities developed their own specialist training programmes, the Master of Medicine (Paediatrics) became another avenue for obtaining specialisation in the field of child health and paediatrics. Most doctors would now undergo a structured training programme over a prescribed period of time before sitting for their qualifying examinations. After graduating, these doctors would likewise go through a period of supervision and be gazetted as specialists thereafter if deemed fit.

In the 'strictest' sense of the word, these trained and qualified doctors with the necessary qualifications are recognised as paediatricians. The public's misconception can arise in two ways. The first is the so called "word of mouth" recommendation. For example, Doctor A, although a general practitioner, may have a special flair for dealing with children and word gets around that this doctor is good with children, the children get well and the parents are pleased with the treatment. Hence, his reputation as a child specialist' in a loose sense of the term.

Secondly, some clinics may advertise as 'Women and Child Clinic' or 'Child Clinic'without stating 'Specialist'. This could be because the doctors concerned may have done a lot of paediatrics during government service or have a natural inclination in this field without the relevant pass in the prerequisite examinations or the proper training. However, these doctors do not claim to be specialists and the misunderstanding arises from the patients and the public themselves.

Malaysian Paediatric Association recognises this predicament of parents in determining whether a relevant private practitioner is a qualified paediatrician. We are rendering our support to the various professional bodies and authorities (e.g. the College of Paediatrics and the Academy of Medicine) involved in drawing up guidelines for credentialling.

This is in keeping with developed nations where specialist registers are kept and updated constantly. It is hoped that when this undertaking is complete, there will no longer be this confusion of who are specialists and who are not!