The letter Globalisation and doctors' movements by Dr LF Ng refers.

One has to be aware that for the sake of maintaining 'standards', the Malaysian government kept on sending medical students to UK or Australia at the cost of RM650,000 per student. But some of these students didn't want to come back and serve the nation which paid their way.

If these students had paid their own way, I wouldn't have any complaints. But they didn't. Ida Bakar MRCS might want to check out the various Masters programmes we have in Malaysia before proclaiming the standard is superb over where she is.

Standards differ depending on where you are, even within a particular country. If one is working in a small, country hospital, then 'world-class training' is not something that one can count on.

Ng seems to blame the Barisan Nasional government for the lack of meritocracy in admission to local medical schools and that the bumiputera students are favoured. While that may be true, it is not the reason for the drop in Malaysian medical qualification standards (if there is one).

He quotes the UK Specialist Training Authority's statistics for the direct entry pathway into the General Medical Council's (GMC) Specialist Register but this is hardly a valid barometer as admission into this register is more politically-based than standards-based.

With the acceptance of more Eastern European countries into EU, you'll see doctors from countries like Greece and Cyprus getting into the GMC register without their standards being questioned.

Look, an Italian who can't speak English cannot be denied a job in the UK whereas a Malaysian graduate from say, Oxford, still needs to take the International English Language Testing System (IELTS) examination. That has got nothing to do with your level of medical competency.

If at all there is a decline in Malaysian medical qualification standards, a more probable cause would be the entirely exam-based education system that we have. Students have been reduced to doing mock exams day in day out from primary school to college.

Some teachers would scrap the music lessons and physical education classes in favour of mock exam sessions so that they (the teachers) would look good when they have a zillion students with a zillion As.

Who cares whether any lessons are learnt? That is the reason why there is a slip in standards, if there is one. In this respect, Ng is right in saying that the BN government has failed us.