Better subject delivery, incentives will make neurology competitive
KUALA LUMPUR: Complexity of the subject and the wide salary gap compared with other medical subfields may be reasons why neurology garners less interest among doctors.
National Specialist Register (NSR) Neurology Subcommittee chairman Professor Datuk Dr Raymond Azman Ali said the field, which deals with anatomy functions and organic disorders of nerves and the nervous system, made it less attractive to specialise in.
“Neurology does not attract many doctors probably because it has been perceived as a difficult speciality, as it is complex and cryptic, unlike cardiology, gastroenterology and so on.
“Currently, the subject is not taught well in medical schools. To get more to take up neurology, it must be made interesting by lecturers.
“It must be made intriguing and easy to understand.
“Now, we have more facilities and better lecturers, which can attract neurology trainees.
“For example, I was the only neurologist in Universiti Kebangsaan Malaysia Medical Centre from the late 1990s to early 2000. I think I have managed to motivate more than 20 doctors to take up neurology,” he said.
Dr Raymond said improvements must be made to ensure that neurological treatment was accessible to those in the Bottom 40 income group.
This could be done by closing the salary gap between private and public practice, he added.
“It is not a glamorous job as say, cardiology, neurosurgery or plastic surgery. Neurologists do not make much money as other specialists in private practice.
“In Singapore, the salaries of private doctors are capped, so any excess they make goes to the government. Can we do it?
“Additionally, like many other specialist services in Malaysia, there is a disproportionately small number of neurologists working in the interior and in Sabah and Sarawak.
“There should be better incentives given to those working in those places.”
Yesterday, the Health Ministry stated that the country needed 200 more neurologists to cater to the high number of stroke patients.
Dr Raymond said the neurologist’s role was crucial in treating stroke patients besides dealing with diseases that affected brain function, such as epilepsy and Parkinson’s.
He said stroke treatment had become highly specialised, with advanced training required to ensure competency in treatments such as thrombolysis, where drugs are injected intravenously to break down blood clots in arteries supplying blood to certain parts of the brain.
A medical expert, who wished to remain anonymous, said almost 80 per cent of Malaysians were prone to ischaemic stroke.
“Generally, strokes are caused by blocked blood vessels that disrupt the supply of blood to the brain.
“They can be caused by high cholesterol level, diabetes and high blood pressure.
“Strokes can happen in two ways.
“First is haemorrhagic stroke, which is caused by bursting of the brain artery due to high blood pressure.
“Treatment requires surgical intervention by neurosurgeons.
“Ischaemic stroke, meanwhile, is quite similar to heart attack, and is caused by blocked arteries and can be treated by restoring the flow of blood to the brain.”