A question of quality

By Samantha Joseph

The quality of our graduates is constantly being questioned and this gives rise to concerns about their marketability and career prospects. The nursing and medical fields are among those that face an apparent glut in graduates, although Malaysia imports specialist nurses and doctors. There is very clearly an imbalance between what the colleges are offering and what the market needs.

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Malaysia’s higher education system has been often questioned, not only for what students face when they are pursuing their education, but also for how students are perceived once they have graduated. ‘Malaysian graduates struggle to get jobs’, ‘Malaysian graduates doomed to mediocrity’ come up the moment you Google ‘Malaysian graduates’. That can’t possibly a good omen.

In 2008, the public system graduated 59,844 students, while the private HEIs produced 26,590 graduates at the bachelors’ degree level, says a report on Graduate Employability in Asia 2012 by Unesco. Subsequently, a large proportion of these graduates had difficulties in finding employment.

Why so? Some say that the fault lies in the system that churns out students still dependent on rote learning to succeed in their careers, an impractical expectation for real life; others blame the excessive number of institutions producing graduates of sub-par quality; and still others say that it’s not because there are not enough jobs, but there are not enough graduates who make the right choice when it comes to the skill set they sign up for.

Employers and even deans at institutions lament the fact that a large number of Malaysian graduates are unable to handle a simple conversation in English – what more take instructions, do research, deal with clients and carry out tasks, all of which require a proficiency in the language.

This issue, at least, is one that cannot be laid at the door of higher education institutions. Here the fault lies with the primary and secondary school systems.

In 2009, the average percentage of unemployed Malaysian graduates was 29.1%, with those in the arts and social sciences faring the worst at 35.4%. Science graduates came in second with 33.2% – perhaps rather shocking in the light of the cultural perception that pursuing an education in the science stream, especially in medicine, nursing and related fields, would virtually guarantee one a job.

In 2011, the Graduates Tracer Study by the Ministry of Education shows that 24% of Malaysian graduates remain unemployed.

Nursing debacle

Nursing graduates have been one of the groups identified as facing dire problems in employability. In fact, some quarters have said that there is a glut in nursing graduates, thanks to the many private institution graduates with diplomas who are unable to find a place when forced to compete with degree holders and public university graduates.

According to Sungai Siput MP Dr Michael Jeyakumar, private colleges produce around 12000 nursing graduates, but the private sector only provides between 1000 to 1500 nursing jobs. What happens to these extra 10500 students? Do they just languish in the ranks of the unemployed? And how did they end up in such a predicament?

In a Dewan Rakyat exchange with Dr Jeyakumar, the Ministry of Higher Education stated that 37, 702 students were enrolled in nursing diplomas at PHEIs in 2010. This is half the number of active, trained nurses according to Liow Tiong Lai, the Minister of Health at the time. In 2010, the number of active, trained nurses was 69,110; 47 992 in the public sector and 21,118 in the private sector.

Employability – in Malaysia at least – looks further and further from the grasp of these students. In totality from 2006 to 2010, the government has only hired a total of 993 diploma holders from private institutions. Diploma graduates from PHEIs not only have to compete with graduates of public universities and PHEI degree holders, but also graduates from Ministry of Health colleges.

The private sector nursing employment market is further squeezed when healthcare providers like Sime Darby, Assunta Hospital and KPJ run their own training institutions. Sime Darby has its Nursing and Health Sciences College, Assunta Hospital the Tun Tan Cheng Lock College of Nursing, and KPJ has KPJ Healthcare University College, and in these cases graduates are absorbed into the respective organisations, removing a significant number of jobs from the already small market.

Similar to entry requirements for other subjects, nursing diplomas require only a specific number of SPM credits to qualify. For nursing, one must have five credits, one of which must be a Math subject and the other a Science subject, either general or pure. Prior to 2012, the requirement was only three credits.

When it was first implemented, four institutes were fined for taking in students who did not make the minimum requirement cut. These four were Institut Teknologi Lanjutan Sarawak, Lincoln University College, Kolej Seri Manjung and International College of Health Sciences.

On their websites, PHEIs often tout working in private and public healthcare organisations as a ‘career prospect’, along with the opportunity to work overseas and collect an income in US dollars. This sadly does not become a reality for many, as the rise in minimum requirements were precipitated by ‘complaints and feedback on nursing graduates who failed to secure jobs after completing their studies due to oversupply’, as then Higher Education Deputy Minister Dr Hou Kok Chung said in 2012.

The idea of high demand existing for nursing has been said to be perpetuated by the less-than-honest marketing and advertising exercises of some private higher education institutions. Nursing is consistently touted as an in-demand career, and that there are ample employment opportunities.

Meanwhile the reality is that in 2010, only 45.5% of nursing diploma holders from PHEIs have found employment.

One of the PHEIs noted to have promoted nursing diplomas during the glut was MAHSA University College, who had taken out a full page advertisement in The Star last year, ostensibly to clarify the situation regarding the oversupply of unemployed nurses from private colleges.

The advertisement dismisses the concern for unemployed nurses by saying that ‘the so-called unemployed nurses are actually students who have obtained ‘diploma in healthcare’ or its equivalent.

A spokesperson from MAHSA University College declined to comment.

While there is insufficient data on diploma in healthcare holders to verify MAHSA’s claims, the Ministry of Education felt that there was sufficient reason to increase nursing entry requirements to reduce the number of nurses and ensure a slightly better standard of graduates to aid them in employment.

Too many medical programmes

Another course hit by ministry concerns are the medical programmes offered by private universities. In 2010, the Ministry of Higher Education and the Ministry of Health imposed a moratorium on medical programmes. The five-year moratorium was implemented to address the glut in housemen and encourage existing institutions to focus more on quality.

Since 2010, concern about the number of doctors serving in Malaysia and the number of medical students graduating began to peak. Currently, there are 21 medical schools in Malaysia. It seems we are overachievers in this area as well: Australia has 19 medical schools, and Thailand, with its far larger population, has 12.

A cause for concern here is that the housemen are not given proper training at private institutions. According to industry observers, this arises from the fact that many of these education providers do not have an attached medical facility to allow training for their medical students, and instead piggyback on the government hospitals that already play host to public university students.

Former Director General of Health Dr Abu Bakar Suleiman said in 2011 that too many medical schools had been allowed to be started in too short a time, citing that this could lead to doctors in Malaysia ‘not being as good as they could be’

“At present, every state wants to have a medical school. But is there a need? Some don’t even have enough training hospitals,” he pointed out.

“There are too many housemen now, so supervising them can be difficult. And we worry they may not get adequate training,” he added.

There is also concern about the ability to recruit the right staff to teach in these institutions. With specialists being scarce and often consumed wholly by the healthcare industry, even established PHEIs have difficulty identifying and hiring educators for their medical programmes.

Once again it seems that Malaysia is going down the path of quantity over quality. But Dr Jayakumar says the fault does not lie solely with the institutions.

“The fault is also with the regulating bodies who actually approve the setting up of these universities and did not foresee this,” he says.

“Different people have a say, mainly Ministry of Education, Malaysian Quality Association, Ministry of Health, and the Malaysian Medical Council. So these bodies are supposed to regulate the quality of education.”

This breakdown in regulating bodies is a visible issue with the education industry in general. The MQA, MoE and other bodies involved in regulation work in isolation instead of tandem, leading to ignored complaints, and institutions that get away with sub-par quality.

Dr Jayakumar claims that much of this laxity towards institutions, especially medical ones, can be traced to political connections. Many bigwigs formerly of the Ministry of Health now accommodate plum positions on the boards of private universities.

There is indeed an impressive list of former high-ranking ministry officials who find themselves on the boards medical PHEIs, in the company of the powerful and politically connected. Dr Abu Bakar himself was the Director General of Health from 1991 to 2001, and is now the president of the International Medical University (IMU); Professor Mohd Ismail Merican held the same role before becoming the current pro-chancellor and chairman of MAHSA University.

Lincoln University College has on its board former First Director and Registrar of the Nursing Board Professor Bibi Florina Abdullah as their Pro-Chancellor and former Deputy Director General of Health Professor Abdul Gani Mohammed Din. Meanwhile, the Chancellor of Masterskill Educations Group’s Asean Metropolitan University (AMU) is the YTM Raja Dato’ Seri Azureen Sultan Azlan Shah, eldest daughter of the Sultan of Perak, and the chairman of the university governing council is Mohamed Nazim Abdul Razak, brother of the premier.

While these appointments do not imply any wrongdoing, it does lend legitimacy to the idea that oftentimes, officials may be slow to act – whether through undue influence or simply lacking the desire to come up against former bosses.

It may be time for the industry to stop expanding outward and start looking inward for survival. As Dr Abu Bakar stated when comparing the early days of the medical higher education industry to what is currently going on, there should be a coordination in terms of what is needed and what the production capacity is. Right now, that is an integral aspect that is sadly lacking.

In the next piece, KiniBiz looks at the role of MQA, the future of the private education industry and expectations of analysts and industry observers on how the market will play itself out.

Yesterday: The business of private education

Tomorrow: Moving forward