History of Emergency Medicine in Malaysia

The concept of emergency health care systems in Malaysia existed since the 1950s. However, it was not systematic nor integrated as it was the most neglected clinical area and no special attention by other specializations. The set up used to be a rather small unit with limited space, run by medical officers and assistant medical officers in some of the district hospitals. It had no triaging system and no separate areas for resuscitation.

Emergency Medicine is the 14th specialty recognised by the Ministry of Health. The program was initially proposed by the dean of the School of Medical Sciences, Universiti Sains Malaysia (USM).  The task to start and run the program was given to Professor Dr Kamarudin Jaalam who was an intensivist with a PhD in ultrasonography in year 1997. In 1998, he collaborated with Professor Dato’ Sri Dr Abu Hassan and MOH, together with help from anaesthesiology department, USM to establish the Master of Emergency Medicine Programme at the university. Dr Wan Aasim Wan Adenan, an anaesthesiologist, who headed the Emergency Department at the USM Hospital joined hands to run the programme and from here, there was no turning back and Emergency Medicine became a specialty on its own. All these strong characters were the champions for the establishment of Emergency Medicine in Malaysia.

The first intake was started in 1998 and by 2002, the first batch of EPs graduated from USM. Out of six, two of them stayed in USM as lecturers and continue running the post-graduate programme while the other four went back to the MOH and were sent to head a few Emergency and Trauma Departments in MOH hospitals. EPs then started the transformation process of each department with proper triaging and treatment zones. The departments were re-organised, and apart from clinical duties for all medical emergencies and trauma cases, they also helped developed pre-hospital care services, disaster plans and drills and one-stop crisis centres.

In view of demand for more EPs, in 2005, the Master of Emergency Medicine Programme was started in the Universiti Kebangsaan Malaysia (UKM) by Professor Dr Ismail Mohd Saiboon and the University of Malaya (UM) by Professor Dr David Choon Siew Kit to increase the number of specialists. From the successful establishment of the post-graduate programmes in these three universities, a conjoint board was established thereafter. All candidates went through similar examinations and examiners in order to pass as a specialist. In time, interests among young doctors to become EP flourished. Emergency Medicine post- graduate programme has become one of the top choices for specialization. By 2006, all major MOH hospitals had EPs.  As in October 2017, there are 272 EPs in MOH hospitals and 63 EPs in public and private universities throughout Malaysia. A few EPs started to join Institut Jantung Negara (IJN) and private hospitals as the hiring demand for this specialty are increasing.  

Birth of College of Emergency Physicians

Before 2011, Emergency Medicine existed as a chapter under College of Surgeons. On 10th September 2011, the College of Emergency Physicians was established, having 31 members for a start. Professor Dr Ismail Mohd Saiboon was the Protem Chairman. Following the first general assembly, Professor Dato’ Sri Dr Abu Hassan Asaari Abdullah was elected to become the first College President. Associate Professor Dr Mohd Idzwan Zakaria became the second President in 2013 and, currently, Dr Mahathar Abdul Wahab is taking charge. The College formed special interest groups in the form of Trauma Care, Toxicology, Pre-hospital Care, Disaster, Medical Emergency Simulation, Emergency Critical Care and Paediatrics Emergency. The College also enters into collaboration with the International Federation for Emergency Medicine (IFEM).

TOPCOM was introduced by Datuk Dr. Alwi Abdul Rahman, the Head of Emergency and Trauma Department in 2013. This is part of the Disaster Medicine training for the emergency physician and public health responders in Malaysia. TOPCOM has included many other training such as CBRNE, HAZMAT, Tactical Medicine, VIP Emergency Response (VIPER), Mass Gathering Medicine and Humanitarian Medicine. Currently, TOPCOM has partnered with WACEM in conducting Disaster Life Simulation and Tabletop Exercise in many countries as part of training modules for the Emergency and Public Health Faculties.