The Department of Orthopaedic Surgery at the University of Malaya (in Singapore) was established in 1952. Prior to this, the teaching of Orthopaedic Surgery at the University was undertaken by the Department of Surgery under the Professor of Surgery and Professor of Clinical Surgery. From a course consisting of 15 weekly classes on fractures for 18 undergraduates in the late 1930s, and the clinical postings in orthopaedic surgery for over 40 students in 1952, the programme now encompasses an exposure to musculoskeletal diseases and trauma in all 5 years of the undergraduate course. Over this time, the spectrum of clinical conditions has also changed, and with it the emphasis on the conditions to be taught; from that dealing primarily with tuberculosis of bones and joints, poliomyelitis, and childhood deformity, to those resulting from degenerative disorders, sports injuries, industrial and motor vehicle accidents, and cancer. The students are now taught orthopaedic surgery in all the major public hospitals. Local postgraduate training programmes for orthopaedic surgery started in the 1980s. From 1993, a more structured training and assessment programme was introduced for basic and advanced training in surgery and orthopaedics. Advanced trainees rotate through the various teaching hospitals to expose them to a wider range of orthopaedic problems as well as teachers. The postgraduate training programme is now well established, and Singapore is accredited by the Royal College of Surgeons of Edinburgh as an orthopaedic training centre for higher surgical training.
Mahathir Mohamad was born in 1925 in Alor Star, Kedah. He entered the King Edward VII College of Medicine in Singapore in 1947 and graduated in 1953. His years in the medical school equipped young Mahathir with the training necessary to assess and diagnose a problem, before dispensing the appropriate treatment. Throughout his later years in the political limelight, Dr Mahathir recognised the very important role the medical college had in laying the strong foundation for his successful career. He joined UMNO in 1945, already interested in politics at the tender age of 20; he was first elected into Parliament in 1964. The vigorous expression of his candid views did not go down well during the troubled days following the 13 May 1969 racial riots and he was expelled from UMNO, his writings were banned, and he was considered a racial extremist. Nevertheless, his intellectual and political influence could not be ignored for long; he returned to Parliament in 1974, and became the fourth, and longest serving, Prime Minister of Malaysia in 1981. Dr Mahathir has found fame as a Malay statesman, and an important Asian leader of the twentieth century with much written, locally and internationally, debating his policies. This article, using Dr Mahathir's own writings, starts with his description of his early life, proceeds to look at his medical career, then touches on his diagnosis of the problems plaguing the Malays, before concluding with his views on the need to stand up to the prejudices and pressures of the Western world. Throughout his life, Dr Mahathir behaved as the ever-diligent medical doctor, constantly studying the symptoms to diagnose the cause of the ills in his community and country, before proceeding to prescribe the correct treatment to restore good health. It is a measure of his integrity and intellectual capability that he did not seek to hide his failures, or cite unfinished work in an attempt to cling to political power.
Tun Dr Mahathir Mohamad was a medical student at the King Edward VII College of Medicine from 1947 to 1953. He described his student days with fondness; he made many friends while he was at the College. He recounted his early days as a doctor before he entered politics in 1964. He became the fourth and longest serving Prime Minister of Malaysia for 22 years from 1981 to 2003. He concluded "The contribution of my Medical College days in Singapore to the racial harmony, peace and prosperity of Malaysia is tangible but unquantifiable."
This article traces briefly the origins of medical education in the early years of the Straits Settlements (Singapore, Penang and Malacca), which culminated in the founding of Medical School in Singapore in 1905. The first attempt was made in the early 19th century, when boys were recruited from local schools as Medical Apprentices to be trained as "assistant doctors". They were to assist the British doctors and doctors from India in running the medical services. This scheme was not successful. There are 3 landmark years in the evolution of medical education in the Straits Settlements, namely 1852, 1867 and 1904. In 1852, the Governor, to relieve the shortage of staff in the Medical Department, instructed the Principal Civil Medical Officer to organise a proper course of training for Medical Apprentices and to establish a local Medical Service. This scheme was also unsuccessful and the Straits Settlements continued to rely on doctors recruited from India. In 1867, the Straits Settlements were transferred from the India Office to the Colonial Office and became a Crown Colony. The Indian Government requested that all its doctors be sent back. This would have led to the collapse of the Straits Settlements Medical Service. As a stop-gap measure, the Governor offered the Indian doctors appointment in the new Straits Settlements Medical Service, and at the same time arranged with the Madras Government for boys from the Straits Settlements to be trained in its Medical Colleges. The first 2 boys were sent in 1869. In 1889, the Principal Civil Medical Officer proposed to the Governor that a Medical School should be founded in Singapore, but not enough candidates passed the preliminary entrance examination. The plan was shelved and boys continued to be sent to Madras for training. In 1902, the Committee on English Education proposed that a Medical School should be started in Singapore, but senior British doctors opposed this. On 8 September 1904, Mr Tan Jiak Kim and other local community leaders petitioned the Governor to start a Medical School, raised enough funds to establish the School and the Straits and Federated Malay States Government Medical School (predecessor of the King Edward VII College of Medicine, and the Faculties of Medicine, University of Singapore and University of Malaya) was founded on 3 July 1905.
The Medical Alumni is unique in being the oldest alumni association with medical, dental and pharmacy graduates from our seminal medical school, that has now evolved into the faculties of medicine in 2 countries, namely Malaysia and Singapore. Founded in 1923, the medical alumni association has undergone several name changes with its evolution and activism. After the Japanese Occupation, it was given its present name in 1947, comprising 3 branches working under a common Constitution operating in 2 separate countries. It is also unique in being the only association recognised by the Registrar of Societies with membership in 2 countries. Following the development of medical professional and academic bodies, the medical alumni wound down its medico-political activities to concentrate on providing social and mutual support for its members and its alma mater.
Gastrointestinal endoscopy started in the early 1970s in Malaysia with the help of Japanese doctors. It has evolved over the past 30 years. The gastrointestinal endoscopy unit at the University of Malaya Medical Centre has been in the forefront in providing endoscopy services to patients as well as training doctors in endoscopy in the country. In recent years, trainees have included those from neighboring countries in South-East Asia. Among our most significant achievements is the organization of regular international therapeutic endoscopy workshops since 1993 where leading endoscopists from throughout the world have accepted our invitation as teaching faculty. In 2008, the World Organization of Digestive Endoscopy accorded the high distinction of Centre of Excellence to the endoscopy unit of the University of Malaya Medical Centre.
Universiti Sains Malaysia is the only institution in Malaysia which incorporates all fields of the neurosciences under one roof. The integration of basic and clinical neurosciences has made it possible for this institution to become an excellent academic and research centre. This article describes the history, academic contributions and scientific progress of neurosciences at Universiti Sains Malaysia.
Charles Wilberforce Daniels was a major pioneer in the early days of the newly-formed medical specialism--tropical medicine. At the London School of Tropical Medicine (LSTM) of which he was a leading stalwart, he took an active part in research, teaching and administration. But like others in the new discipline he spent a great deal of time at various tropical locations: Fiji, British Guiana--where he made important observations on various forms of filariasis-- east Africa, and Malaya. However, his most important research contribution was arguably confirmation of Ronald Ross' 1898 discovery of the complete life-cycle of avian malaria, in Calcutta.
Dealing with malaria in the last 60 years is seen by the author in the perspective of his own experience. His malaria work, which began in 1941, covered the study of the habits of the mosquitoes dwelling in the savanna country of Eastern Colombia and the effect on malaria transmission of the newly introduced DDT residual spraying. The success of the campaign he later directed in Sarawak and Brunei contributed to the launching by WHO of its global malaria eradication campaign. Further successful work in Uganda showed the possibility of effective control and even eradication in highland country but left unsolved the problem of how to interrupt transmission of holoendemic malaria in Africa. The author's work with WHO in the Middle East showed to what extent social and economic conditions could influence the course of a malaria campaign. This was also the experience in America, both in Colombia in the author's early work and later in Mexico during an evaluation of the national malaria programme. Development of insecticide resistance was also encountered in his career and the refractoriness of the European vectors was also observed in his work as a malariologist.
Following the discovery of mosquito transmission of malaria, the theory and practice of malaria control by general and selective removal of specific vector populations resulted particularly from Malcolm Watson's empirical work in peninsular Malaysia, first in the urban and peri-urban areas of Klang and Port Swettenham and subsequently in the rural rubber plantations, and from the work of N.H. Swellengrebel in nearby Indonesia on the taxonomy, ecology and control of anophelines. They developed the concept of species sanitation: the selective modification of the environment to render a particular anopheline of no importance as a vector in a particular situation. The lack of progress along these lines in India at that time is contrasted with that in south-east Asia. The extension of species sanitation and related concepts to other geographical areas and to other vector-borne disease situations is outlined.
Infant and child mortality rates have dropped sharply for all ethnic groups in Malaysia between 1950 and 1988, but persistent ethnic differences remain. In this article we assess the contribution of several potential reasons both for the decline and the remaining differences between the Malay and Chinese sub-populations. Increased use of health inputs is found to explain a substantial part of the decline, but increased education of mothers, and income growth are also important. Longer spacing between births, and, higher average age at birth as a result of lower fertility and higher age at marriage provide only a marginal direct contribution to the fall in mortality. We find that lower mortality among the Chinese is accounted for by their higher incomes and greater propensty to purchase medical care. We also control for self-selection among users of medical care, and find that those who use health care in Malaysia tend to be subject to higher-than-average risks.
The invasion of Singapore and Malaya was delayed because of the reduction in the period of service in the Far East. The atom bombs were then dropped and plans for all services including medical ones had to be altered, their main aim becoming the treatment and repatriation of surviving prisoners of war. The ending of the war did not occur abruptly on V-J day; many Japanese troops had to be convinced that the war was over. Meantime the treatment of diseases in British and other service men continued; reference is made to some experiences in Rangoon. The morale of personnel who now were anxious to return to their homes was low and efforts were made to raise their spirits. In India it was accepted that the days of British rule were over.