A TEACHING HOSPITAL OR

AN ACADEMIC MEDICAL CENTER

(HOSPITAL) ?
LOKMAN SAIM

HOSPITAL

General hospital
University hospital
Teaching hospital
Public hospital
Private hospital
? Academic hospital

HOSPITAL AND TEACHING ACTIVITIES

University Hospital
Hospital that belongs to a university with a
medical/health sciences schools

Teaching Hospital
Any hospital that is used for teaching activities

Academic Medical Center (Hospital)

What is an academic medical center ?
Patient centered, student centered

CURRENT TREND
A need for stronger cooperation and
partnership in health service and education
Integration of vision, mission, objectives and
organizational structure to support service,
teaching and research
Evolution of Academic Medical Center or
Academic Hospital

ACADEMIC MEDICAL CENTER

DEFINITION :Institution that integrates one or
more hospitals or health systems , a medical
school, and one or more other health
professional schools.
Integrated center with tripartite missions
Excellent medical and health services
Excellent education
Excellent research
One vision and leadership.

MINISTRY OF HEALTH HOSPITALS teaching

hospital but ? an academic hospital
Hospitals Ministry of
Health
Medical Schools
University, Ministry of
Higher Education
Differing policies
Differing priorities
Student vs patient
Dean vs Hospital Director

WHAT ABOUT PRIVATE

HOSPITAL?

 TRANSFORMATION TO AN
ACADEMIC HOSPITAL

Strong leadership engagement

Accept symbiotic relationship between
excellent clinical care, scientific research and
medical/health education.
orient and organize the more broad hospital
activities
Adopt a confluence of policy.Patients,
staffs,.. students and trainees.

TRANSFORMATION IN HEALTHCARE
The Johns Hopkins Hospital and Health System
For more than a century, Johns Hopkins has been
recognized as a leader in patient care, medical
research and teaching. Today, Johns Hopkins
Medicine is known for its excellent faculty, nurses
and staff specializing in every aspect of medical
care. The Johns Hopkins Health System includes
three acute-care hospitals and programs for local,
national and international patient activities

TRANSFORMATION IN HEALTHCARE
Imperial named Academic Health Science Centre
Imperial College London and Imperial College Healthcare NHS
Trust today welcomed the Department of Healths formal
designation of their partnership as an Academic Health Science
Centre (AHSC).
AHSC status has been awarded to just five partnerships in the UK,
and designation signals international excellence in biomedical
research, education and patient care. The prestigious AHSC status
was awarded after a rigorous six-month review process led by an
all-international scrutiny panel of medical experts.
Imperial College Healthcare NHS Trust and Imperial College London
have been working together as an AHSC since October 2007
following the merger of Hammersmith and St Marys NHS Trusts
and the new Trusts integration with Imperial College London.

TRANSFORMATION IN HEALTHCRE
National University Health System (NUHS)
is an academic medical centre located in
Singapore. It was established in January 2008 as a
joint venture between the National University of
Singapore and Singapore's MOH Holdings Pte Ltd.
NUHS groups the National University Hospital
(NUH) with the National University of Singapore's
(NUS) Yong Loo Lin School of Medicine and
Faculty of Dentistry under a common governance
structure in order to develop and promote
academic medicine.

ACADEMIC MEDICAL CENTER

There are currently AMCs in operation in
Canada, the Netherlands, Singapore, Sweden,
the United Kingdom and the United States.[2]
The 16 highest ranked hospitals in the U.S.
were all AMCs.[2]

POLICIES ON PATIENTS, STUDENTS

AND TRAINEES
policies need to be developed and serve as the
foundation for the hospital administration
commitment towards becoming an academic
hospital
the policies should engage a broad range of
stakeholders to create clear expectations for the
shared mission of excellent patient care,
education and research
policies will align goals of patient care with the
academic programmes of teaching, training and
research.

HOSPITAL POLICY ON STUDENTS AND

TRAINEES
most vulnerable group of individuals, often
sidelined by hospital administrators
consistency with educational objectives
guidelines for acceptable standards of
professional behaviour
Expected students behavior

provide parameters for safe clinical practice

personal health and safety

POLICY ON FACILITIES

Students facilities
Academic facilities
Use of the computers, internet
Clinic rooms for students/trainees clerking of
patients
Use of specific diagnostic instruments
endoscopes, microscopes, etc

SPECIFIC CONSIDERATION IN PRIVATE

HOSPITALS

TRANSFORMATION AND INNOVATIONS

Number of students/trainees

Small number, distribution to a group of hospitals

Ratio of trainee : trainer

One-to-one apprenticeship training

Consent for training activities

Competency-based training
Close supervision by trainer

ACADEMIC MEDICAL CENTER IN KPJ?

NILAI SPECIALIST HOSPITAL

(KPJUC ACADEMIC MEDICAL CENTER)

MISSION
KPJ HEALTHCARE BHD aspires to continue as the
forerunner and leader in healthcare delivery and the
development of innovative, efficient and effective
health care education and research . An important
factor for this mission is the provision and development
of the physical resources that are able to support the
expected outcomes of this mission. One of the key
infrastructure is the establishment of an ACADEMIC
MEDICAL CENTER.

THE CONCEPT
The new facilities will physically demonstrate the platform and
extent of integration between all the academic faculties,
teaching hospital and research facilities. This is to be achieved
through the creation of integrated, interdisciplinary and modern
teaching hospital, laboratories and health clinics that will support
the developing and demanding needs of undergraduate,
graduate, clinical and research work. The facilities should be able
to sustain program integration and interdisciplinary health care in
an environment of team health care delivery.

PRINCIPLES OF IMPLEMENTATION
A dedicated academic medical center for
excellent patient care, education and research.
Team approach in patient care involving
medical physicians, healthcare professionals and
other supportive care providers.
Break the traditional individual practice in private
hospitals.
Recalibrate institutional structure teaching,
research and health services based on
multidisciplinary centers of excellence under one
organizational structure.

FOLLOW CURRENT TREND

Partnership in health service, education and
research
Team practice rather than individual practice
Stronger cooperation between disciplines in
healthcare (multi-disciplinary care)
Evolution of Academic Medical Center or
Academic Hospital.

BUILDING FEATURES
200 bed hospital
Standard features of a private specialist
hospital
Medical consultants
Cluster clinics, including for student clerking
Consultant cluster/division office

Medical officers
Medical officer/ master student room
On call rooms

BUILDING FEATURES
Students
Student center
Tutorial rooms

Clinical examination ward

convertible to normal ward

Tele-video conference facilities

Clinical Skills laboratory
Research Center

HUMAN RESOURCE
Specialty

No

1.

General Medicine

2.

General Surgery

3.

Paediatrics

4.

Obstetrics and Gynecology

5.

Orthopedics

6.

ENT

7.

Opthalmology

8.

Psychiatry

9.

Family medicine

10.

Emergency medicine

11

Anaesthesiology

12.

Radiology

HUMAN RESOURCE : NEW CONCEPTS

Salaried clinicians
Dual employment : Employment by KPJUC and
Hospital
Lecturer functioning as clinician
Clinicians
Lecturer/specialist (40%)
Associate Prof. / consultant) (30%)
Professor/ Senior consultant (30%)

ACADEMIC HEALTH CENTER MODEL

IN MALAYSIA
There is no private academic medical center
model in Malaysia.
No financial model yet.

There are currently AMCs in operation in

Canada, the Netherlands, Singapore, Sweden,
the United Kingdom and the United States.[2]
Highest ranked hospitals in the U.S. were all
AMCs.[2]

CHALLENGES
Acceptance of the tri-partite mission of a private
medical center integration of excellent
healthcare, teaching and research.
To break the tradition of individual private
practice in private hospitals.
Salaried medical consultants practicing as a team
in private hospitals.
Public perception towards teaching and research
activities in private hospitals.
No financial model in Malaysia.

OPPORTUNITIES
KPJ Healthcare Bhd as an established healthcare institution providing leadership role in academic medical center in the region.
Numerous private academic medical centers in USA and as models
eg. Mayo Clinics, John Hopkins
KPJUC clinical lecturers as clinician, academician and researcher.
Potential for trainees sponsored by KPJ Healthcare in the medical
specialty training programme (Masters programme) as clinical
lecturers.
Very competitive places for training of MOs in Malaysia better
opportunities for practice and training in private medical centers.

CONCLUSION
Transformation into academic hospitals
Engagement in patient care, education and
research
Private hospitals and professional talents in
private hospitals have great potential in
contributing to education and training of health
professionals
Have clear and effective trainee and student
policy inclusion of stakeholders in its
formulation

 Implement policies that provide parameters for

excellent patient care and facilitate education and
training.
Consistency in education and clinical training
provides good guidelines for trainees personal
and professional development
Inclusive policies make students and trainees
become more aware of their personal
responsibility and accountability and realize that
they are part of the larger hospital community
responsible for the care of the patient.

CONCLUSION
KPJ ACADEMIC MEDICAL CENTER (KPJ NILAI
SPECIALIST HOSPITAL) can be the first private
institution that will be able to offer
comprehensive, cutting edge patient care,
have large and excellent translational
research as well as trains the health care
professionals of the future.