NOTE ON ADMINISTRATIVE ARRANGEMENTS

ANNEX D1

ARF DiREx 2015 Medical License

LICENSES AND CLEARANCES

Medical Licensing and Credentials

Regulations over foreign health workers are enforced by Ministry of Health (MOH) Malaysia, along with the Malaysian Medical Council.

APPLICATION FOR TEMPORARY PRACTISING CERTIFICATE (TPC)

GENERAL INFORMATION AND GUIDELINES

A Temporary Practising Certificate (TPC) is issued under Section 16(1) of the Medical Act

1971.

Section 16(1) : Notwithstanding anything to the contrary contained in this Act, the Council

may, upon application in writing, issue to a person who is registered as a medical

practitioner outside Malaysia a temporary certificate to practice as a medical practitioner,

subject to such conditions and restrictions as the Council may specify in such certificate, for

a period not exceeding three months.

A. Objective of TPC:

To enable a medical practitioner to practice medicine for a period not more than 3 months in Malaysia. An extension may be considered on application.

B. Purpose of TPC:

1. To conduct courses/seminars/workshops

2. To undergo clinical training/fellowships/masters programs in local universities/medical institutes.

C. Application for TPC:

1. A practitioner registered with the Malaysian Medical Council with valid and current Annual Practising Certificate must complete an application form in full.

2. The application must be accompanied by list of documents stated.

D. Processing of TPC:

1. Application will be forwarded to the Evaluation Committee for evaluation.

2. The institute will be notified in writing on the Evaluation Committees decision.

E. Important Notice:1. Please ensure that your application is submitted at least 6 (SIX) WEEKS prior to date of commencing practice as the Evaluation Committee sits only once a month.

2. Application must be tendered in 7 (SEVEN) COPIES.

(NOTE: Only one set needs to be original certified true copy.)

3. This application must be filled by the institution applying.

4. Submit this application and documents required via Diplomatic Channel to:

ASEAN-Malaysia National SecretariatMinistry of Foreign Affairs, Malaysia

LIST OF DOCUMENTS FOR SUPPORTING THE TEMPORARY PRACTISING

CERTIFICATE (T.P.C.) APPLICATION UNDER SECTION 16 OF THE MEDICAL

ACT, 1971

1. Application form for T.P.C. (to be type written)

2. Curriculum Vitae of the applicant (to be type written)

3. Certified true copy of basic medical degree.

4. Certified true copy of post graduate degree(s)

5. Certified true copy of full registration certificate from Medical Council or Medical

Licensing Authority of the country of practice.

6. Current and original Letter of Good Standing from Medical Council or Medical

Licensing Authority of the country of practice.

7. Certified true copy of testimonials of working experience from the completion of

housemanship until now.

(Note : Every working experience given in the curriculum vitae must be supported by

certified true copy / copies of testimonial from Head of Department/ supervisor concerned)

8. Certified true copy of Passport (in A4 size paper).

9. Certified true copy of Medical Indemnity.

IMPORTANT TO SUBMIT YOUR APPLICATION AT LEAST 6 WEEKS IN ADVANCE

OF THE DATE ON WHICH YOU WOULD LIKE YOUR TPC TO BEGIN.

APPLICATION FOR TEMPORARY PRACTISING CERTIFICATE (T.P.C) UNDER

SECTION 16 OF THE MEDICAL ACT, 1971

INSTITUTION APPLYING:

1. Name: .

2. Address: .....................................................

.........................................................

3. Tel. No: ................................................ Fax No: ............................................

4. Department:............................................................

LOCAL REGISTERED PRACTITIONER RESPONSIBLE FOR THE APPLICANT WHILST

PRACTISING IN MALAYSIA:DEPUTY DIRECTOR GENERAL OF HEALTH (MEDICAL),

MINISTRY OF HEALTH MALAYSIA.

FOR ARF DIREX 2015 USE ONLYCURRICULUM VITAE OF PRACTITIONER APPLYING FOR TPC:

8. Name (in Full and Capital Letters): ................................................................

9. Citizenship: .............................................................

10. Basic Medical Qualification:

a. University Awarding the Basic Medical Degree: ..

b. Year degree awarded: ...

11. Post Graduate qualification/s:

a. University Awarding the Postgraduate Medical Degree: ..

b. Year degree awarded: ...

12. Licensing Authority:

a. Name of Registering Medical Council or Licensing Authority in Country of Practice:

...

b. Full Registration No. : ................ Date issued : ........../............./..................

c. Letter of Good Standing:

Number: ...................

Date issued : ....../............./.................

Date expired: ........./............./.................

d. Medical Insurance Coverage: (Note: Please submit certified true copies)

Name of Medical Insurance Body: ...................

Certificate No. : ....../............./.................

Date expired: ........./............./.................

PURPOSE, PLACE AND PERIOD OF TPC:

13. Purpose for applying TPC: (please tick one)

FOR ARF DIREX 2015 USE ONLY14. Place and Period of Practice: (Not more than 3 (three) months)

ARF DIREX IN PERLIS, MALAYSIA : FROM 25TH 29 MAY 2015 ONLYDECLARATION: (To be signed by the Local Registered Medical Practitioner)

I hereby agree to assume full responsibility for the management of patients treated by the

applicant Dr. .... during his period of practice in

this country.

Signature : ............................................ Date : ........./............/...

Name of Local Practitioner: ...........................

Rubber stamp of the applying institution:

LIST OF DOCUMENTS FOR SUPPORTING THE TEMPORARY PRACTISING

CERTIFICATE (T.P.C.) APPLICATION UNDER SECTION 16 OF THE MEDICAL ACT,

1971

1. Application form for T.P.C. (to be type written)

2. Curriculum Vitae of the applicant (to be type written)

3. Certified true copy of basic medical degree.

4. Certified true copy of post graduate degree(s)

5. Certified true copy of full registration certificate from Medical Council or Medical Licensing

Authority of the country of practice.

6. Current and original Letter of Good Standing from Medical Council or Medical Licensing

Authority of the country of practice.

7. Certified true copy of testimonials of working experience from the completion of housemanship

until now.

(Note : Every working experience given in the curriculum vitae must be supported by certified

true copy / copies of testimonial from Head of Department/ supervisor concerned)

8. Certified true copy of Passport (in A4 size paper).

9. Certified true copy of Medical Indemnity.IMPORTANT TO SUBMIT YOUR APPLICATION AT LEAST 6 WEEKS IN ADVANCE OF

THE DATE ON WHICH YOU WOULD LIKE YOUR TPC TO BEGIN.MEDICAL RESPONSEObjectives of the Medical Response1. To enhance confidence and to develop mutual understanding among ARF participants in the context of multinational disaster relief operations by active involvement in various medical activities.

2. To strengthen multinational medical response through organized collaboration and teamwork of all medical activities which includes: Needs AssessmentTriage

First-Aid & Emergency Medical Treatment

Patient Movement & Evacuation

Mental Health & Psychosocial activities

Forensic activity

3. To address each others needs and concerns during humanitarian aid assistance.

4. To establish an organized coordination system in multinational medical response for future mission.

5. To improve civilian-led military-supported disaster operations and civil-military coordination at operational and tactical level.

MEDICAL OPERATING MANUAL ARF DiREx 20151.Overview1.1 ARF DiREx 2015 is an opportunity for ASEAN countries to prepare medical team in facing disasters in a well-coordinated civil-military approach.1.2 Medical activity is considered to be one of the most important components of disaster response due to the fact that it is directly related to life saving activities.

2.Structure2.1 Medical Incident Coordinator (MIC) is stationed at EOC during the disaster response. 2.2 Only appointed officials can operate at the EOC.2.3 Medical Scene Controllers shall coordinate and control the medical activities during the exercise.2.4 On Scene Medical Commander (OMC) shall be the overall commander for all medical related activities at site.

3. Accommodation

3.1 Every medical team will lodge at the appointed venue (hotel) as per registration.

3.2 For camping, please follow the SAR operating manual.

4.Logistics4.1 Medicines

4.1.1All participants are advised to bring along their own prescribed medicines.4.1.2If the need arise, emergency medical treatment shall be provided by the Malaysian medical team.4.2Oxygen4.3.1 4.2.1Oxygen shall be provided via appointed Liaison Officer once request is made. Cost shall be borne by participating countries

4.4 Electricity/Generator Set & Fuel4.4.1 SAR medical team should be self-sufficient in providing own electricity supply.Cost of additional fuel supply shall be borne by participating countries upon request made to appointed Liaison Officer4.5 Food

4.4.1All participants are expected to have their own personal packed ration.

4.6 Water for field hospital will be provided by host country.

5.Communication5.1 Each participating team will have to bring their own communication devices.

5.2 It is advised to have English speaking personnel from each participating country.

5.3 Interagency communication among medical personnel shall be done through an elected liaison officer under the command of Malaysian Medical Officer Liaison Officer (MELO).

5.4 Countries who plan to utilize own radio communication system are advised to get approval from host country.

6. Refreshments and Restroom Facilities

6.1 Refreshments and portable water will be provided for all exercise participants throughout the exercise. Restrooms facilities will be available at each venue.

7. Assignment & Report7.1 Upon arrival into the host country, the leader of each medical team shall report to EOC. MIC (Medical Incident Coordinator) at EOC shall coordinate further arrangement for deployment of the teams to the site.7.2 Each dispatched medical team shall elect a team leader and this must be made known to the MIC. 7.3 At the incident site, team leader must first report to the OnScene Commander (OSC) which is the police and once entry to site ground is obtained to report to the On Scene Medical Commander (OMC) and work under the command and coordination of the OMC during their duration of stay.7.4 All Medical team response deployment at the incident sites shall be coordinated by the OMC.

8.Temporary License8.1 All Medical Team members are requested to apply for the Temporary Practising Certificate ( TPC) available in the ARF Direx Website. This process is only valid for the duration of the ARF DIREX and only to be used for DIREX purposes only. ( TPC Forms available in the above section on pages 5 and 6)

8.2 The registered team members are only allowed to treat the simulated victims in the exercise.

8.3 All real victims shall be attended to by the Malaysian medical team on standby at each site.8.4 Foreign medical teams do not require a temporary license to treat personnel from their own country.

9.Type of Mission9.1 Medical activities at the incident site:9.1.1 Medical Rescue activities

9.1.2 Triage

9.1.3 First Aid and Emergency Medical Care

9.1.4 Patient movement & Evacuation

9.1.5 Mental Health & Psychosocial activities

9.1.6 Forensic activities

9.2 Establishment of forward medical post, medical base station and field hospital.

9.3 Only trained and well equipped medical personnel are allowed to enter the red zone to assist in SAR activities.

10. Real Patient Medical Treatment10.1 Real patients will be attended to by the Malaysian medical standby team at each site.10.2 If required, real victims shall be evacuated to the designated hospital.10.3 Transportation of real patients shall be coordinated by the medical scene controller assisted by the medical standby team at each site.10.4 In the event of the occurrence of real victims, the medical scene controller has the duty to inform the MIC at the EOC.

11.Field hospitals11.1 Field hospital shall be set up in order to provide virtual casualties with necessary medical care . 11.2 The field hospital should be able to provide operation and hospitalization facilities.11.3 The level of field hospital is to follow the Medical Support Manual for United Nations Peacekeeping Operation (Chapter 3, 3.04-Structure of medical support in peacekeeping Operation pg 19-22) as stated below:

STRUCTURE OF MEDICAL SUPPORTA. Basic Level.This effectively refers to basic First Aid and preventive medicine practised. As there is no doctor present, care is provided by a trained paramedic or nurse, using basic medical equipment and supplies.

B. Level One Medical Support.This is the first level where a doctor is available. It provides first line primary health care, emergency resuscitation, stabilization and evacuation of casualties to the next level of medical care within a peacekeeping mission.

A Level One medical unit is to have adequate medical supplies and consumables for up to 60 days.

Tasks of Level One Medical Unit:1. Provide primary health care with the capacity to treat at least 20 ambulatory patients per day.

2. Perform minor surgical procedures under local anaesthesia, e.g. toilet and suture of wounds, excision of lumps.

3. Perform emergency resuscitation procedures such as maintenance of airway and breathing, control of hemorrhage and treatment of shock.

4. Triage, stabilize and evacuate a casualty to the next level of medical care.

5. Ward up to 5 patients for up to 2 days each, for monitoring and inpatient treatment

6. Administer vaccinations and other disease prophylaxis measures required in the mission area.

7. Perform basic field diagnostic and laboratory tests.

8. Maintain the capability to split into separate Forward Medical Teams (FMTs) to provide medical support simultaneously in two locations.

9. Oversees implementation of preventive medicine measures for the contingents and personnel under their care

Level Two Medical Support.This is the next level of medical care and the first level where surgical expertise and facilities are available. The mission of a Level Two medical facility is to provide second line health care, emergency resuscitation and stabilization, limb and life-saving surgical interventions, basic dental care and casualty evacuation to the next echelon.

Tasks of Level Two Medical Unit:1. Provide primary health care with the capacity of treating up to 40 ambulatory patients per day

2. Perform limb and life saving surgery such as laparotomy, appendectomy, thoracocentesis, wound exploration and debridement, fracture fixation and amputation. This must have the capacity to perform 3-4 major surgical procedures under general anesthesia per day.

3. Perform emergency resuscitation procedures such as maintenance of airway, breathing and circulation and advanced life support, hemorrhage control, and other life and limb saving emergency procedures.

4. Triage, stabilize and evacuate casualties to the next echelon of medical care.

5. Hospitalize up to 20 patients for up to seven days each for in-patient treatment and care, including intensive care monitoring for 1-2 patients.

6. Perform up to 10 basic radiological (x-ray) examinations per day.

7. Treat up to 10 dental cases per day, including pain relief, extractions, fillings and infection control.

8. Administer vaccinations and other disease prophylaxis measures as required in the mission area.

9. Perform up to 20 diagnostic laboratory tests per day, including basic hematology, blood biochemistry and urinalysis.

10. Constitute and deploy at least 2 FMTs (comprising 1 x doctor and 2 x paramedics) to provide medical care at secondary locations or medical support during land and air evacuation.

11. Maintain adequate medical supplies and consumables for up to 60 days, and the capability to resupply Level One units in the Mission area, if required.

D. Level Three Medical Support.

This is the highest level of medical care provided. It combines the capabilities of Level One and Two units, with the additional capability of providing specialized in-patient treatment and surgery, as well as extensive diagnostic services. It is important to note that a Level Three unit is rarely deployed, and that this level of support is generally obtained from existing civilian or military hospitals within the Mission area or in a neighboring country.

Tasks of Level Three Medical Unit:1. Provide primary health care with the capacity to treat up to 60 ambulatory patients per day.

2. Provide specialist medical consultation services, particularly in areas like Internal Medicine, Infectious Diseases, Tropical Medicine, Dermatology, Psychiatry and Gynaecology.

3. Perform up to 10 major general and orthopedic surgical procedures under general anesthesia per day. Availability of specialist surgical disciplines (e.g. neurosurgery, cardio- thoracic surgery, trauma surgery, urology, burns unit) is an advantage.

4. Perform emergency resuscitation procedures such as maintenance of airway, breathing and circulation and advanced life support.

5. Stabilize casualties for long-haul air evacuation to a Level 4 facility, which may be located in another country.

6. Hospitalize up to 50 patients for up to 30 days each for in- patient treatment and care, and up to 4 patients for intensive care and monitoring.

7. Perform up to 20 basic radiological (x-ray) examinations per day. Availability of ultra-sonography or CT scan capability is an advantage.

8. Treat 10-20 dental cases per day, including pain relief, extractions, fillings and infection control, as well as limited oral surgery.

9. Administer vaccination and other preventive medicine measures, including vector control in the mission area.

10. Perform up to 40 diagnostic laboratory tests per day.

11. Constitute and deploy at least two FMTs (comprising 1 x doctor and 2 x paramedics) to provide medical care at secondary locations or medical support during casualty evacuation by land, rotary and fixed-wing aircraft.

12. Maintain adequate medical supplies and consumables for up to 60 days, and the capability of limited resupply Level One and Level Two medical units, if required.

E. Level Four Medical Support.A Level Four medical facility provides definitive medical care and specialist medical treatment unavailable or impractical to provide for within a Mission area. This includes specialist surgical and medical procedures, reconstruction, rehabilitation and convalescence. Such treatment is highly specialized and costly, and may be required for a long duration.

Indications for Level 4 facilities include:

1. When the distance from Mission area to the country of origin is too far, and the patient or casualty is in urgent need of specialist medical treatment.

2. When the patient requires only short-term specialist treatment and is expected to return to duty within 30 days.

3. When the country is unable to provide appropriate definitive treatment (this excludes chronic medical conditions diagnosed prior to the deployment into the Mission area, or for which he is already receiving treatment).

F. Forward Medical Team.A Forward Medical Team (FMT) is a small, highly mobile medical unit of about 3 men that is configured and equipped to provide short-term medical support in the field. This is generally constituted as and when required from existing medical units within the Mission area (including personnel, equipment and supplies..

Tasks of Forward Medical Team:1. To provide primary healthcare and emergency medical services at a medical post supporting a contingent of about 100-150 personnel.

2. To provide first line medical support for short-term field operations in areas without immediate access to medical facilities.

3. To provide continuous medical care during land and/or air evacuation of casualties particularly for seriously ill or unstable casualties, and where evacuation distances are long or where delays are anticipated. This includes medical evacuation out of the affected area.

4. To provide a medical team for Search and Rescue missions.

To function effectively in the above operations, it is important for FMTs to be well equipped despite their size, including the requirement for life-support medical equipment. All equipment and supplies need to be portable and configured for use in confined spaces like ambulances and helicopters. There may be a requirement for electrical equipment to be aviation-certified for use within aircraft.

12.Referral hospitals12.1 Hospital Tuanku Fauziah in Kangar shall be the designated referral hospital and primary receiving hospital. Hospital Sultanah Bahiyah shall be the secondary responding hospital.12.2 Virtual requests shall be made for patient movements from SAR site and field hospital to referral hospital through the OMC. However patient movement exercise ends when the patient gets on designated transportation.12.3 It shall not be activated during the exercise as it is only activated for receiving real victims.

13. Forensic activities

13.1 Any death declaration and documentation can only be made by a Malaysian medical practitioner.13.2 All death must be reported to MIC who will then alert the relevant authorities for further action.13.3 Forensic activity can only be carried out by the Malaysian police following host countrys SOP.11.Real EmergenciesAt site:

11.1 The standby medical team shall be responsible to render treatment at site11.2 The team shall also be responsible for the transportation of the injured/ill person to the hospital if needed.

11.3 Hospital charges incurred shall be the participants responsibility.

Off site:

11.4 All injured/ill participants shall be managed using the MERS999 emergency system.

11.5 The medical cost shall be borne by the patient.

12.Reporting12.1 Medical scene controllers must submit a report upon completion of each FTX to the medical exercise coordinator (MEC).12.2 Foreign medical team should submit a final report to the MIC in EOC.RESPONSIBILITIES OF TTX & FTX MED WORKGROUPS

Formulate and finalized plans for all medical related activities at all incident sites.

To provide medical assistance in case of any injury/illness among participants.

Obtain permission for medical activities from relevant authority.FTX FLOW FOR MEDICAL RESPONSE

EXPECTED OUTCOME OF MEDICAL AND HEALTH MANAGEMENT Improvement of medical service during disaster through the coordination between all medical groups. Reinforcements of national and international civil-military collaboration during disaster response.RESPONSIBILITIES OF STANDBY MEDICAL TEAM

Provide emergency medical care for participants in case of an actual emergency

Responsible for the medical management of real injured/ill participants.

Provide patient transfer services by ambulances and/or helicopters and/or boat to designated hospital. Monitoring the health status of all members of rescue teams as well as medical teams

Conduct forensic activities

1

WORK PROCESS FOR REQUEST OF FOREIGN MEDICAL SERVICES

OMC PERFORMS SITREPOMC REQUEST FOR FOREIGN MEDICAL ASSISTANCE

REQUEST FROM OMC RECEIVED BY ONSCENE COMMANDER ATCOMMAND CENTRE

REQUEST RELAYED TO MIC (MEDICAL INCIDENT COORDINATOR) AT EOC

MIC (MEDICAL INCIDENT COORDINATOR) AT EOC FORWARDS REQUEST TO IOCC

IOCC COORDINATES FOREIGN MEDICAL ASSISTANCE REQUEST

IOCC INFORMS MIC AT EOC REGARDING FOREIGN MEDICAL ASSISTANCE ACCEPTANCE

WORK PROCESS FOR ON- SITE MEDICAL SERVICES (LOCAL)

MEDICAL TEAM ARRIVES AT THE SITE

REPORT TO COMMAND CENTRE (ONSCENE COMMANDER)

ESTABLISH STATION AT THE YELLOW ZONE

TRIAGE SIEVE AT CASUALTY COLLECTING POINT

TAG & TRANSFER

EVACUATION

TREATMENT AREA

RED

YELLOW

GREEN

ESTABLISH TEMP BODY AREA(POLICE)

MGT.OF INJURED RESCUER

ORGANISE SEARCH & RESCUE TEAM

DETERMINE ABILITY TO CONTINUE WORKING

COORDINATION OF TEAMMEMBERS WITH OTHERRESCUE PERSONEL

TRIAGE SORT

REPORT TO OMC (ONSITE MEDICAL COMMANDER)

ON SITE MANAGEMENT : MEDICAL SERVICES

YELLOW ZONE

OSC(POLICE )

FORWARD FIELD COMMANDERFFC

SAR TEAM

RED ZONE

WORK MATRIX

COMMAND POST

O.M.C.

FIRE & RESCUE

MEDICAL BASESTATION

REDYELLOW

FORENSIC

M.E.L.O.

LOGISTICS

M.E.S.A.R.O.

SAR

SAR

FORWARD MEDICAL POST

SJAMMRCSCDEMRS

GREEN

WHITE

REPORT TO ONSITE MEDICAL COMMANDER (OMC)

FORWARD MEDICAL POST (FMP)

MEDICAL BASE STATION (MBS)/FH

BRIEFING BY MEDICAL INCIDENT COORDINATOR (MIC)

BASE MEDICAL COMMANDER

REPORT AT EOC

MERT

MESARO

MERT

WORK PROCESS FOR FOREIGN MEDICAL TEAMS

ARRIVAL IN MALAYSIA

MH PRT COMMANDERFORENSIC COMMANDERHEALTH COMMANDER

TO SITE

REPORT TO ONSCENE COMMANDER ( OSC)

WORK PROCESS UPON STAND DOWN OF FOREIGN MEDICAL SERVICES

OMC PERFORMS SITREPOMC STANDS DOWN ON FOREIGN MEDICAL ASSISTANCE

OMC INFORMS ONSCENE COMMANDER ATCOMMAND CENTRE ON MEDICAL STAND DOWN

STAND DOWN RELAYED TO MIC (MEDICAL INCIDENT COORDINATOR) AT EOC

MIC (MEDICAL INCIDENT COORDINATOR) AT EOC INFORMS IOCC

IOCC COORDINATES DEPARTURE OF FOREIGN MEDICAL TEAMS

STAND DOWN RELAYED TO MIC (MEDICAL INCIDENT COORDINATOR) AT EOC BY OMC

FOREIGN MEDICAL TEAMS REPORT TO MIC

Incident AreaHigh Risk Zone

RESPONDER STAGING AREA

Fire Base Station

Medical Base

COMMAND CENTRE(TACTICS ZONE)

PRESS

Family & Relative

Ambulance HQ Transportation

STRATEGY ZONE

On Scene CommanderPOLICE( OSC )

OnSite Medical Commander( OMC )

Forward FieldCommanderFIRE & RESCUE (FFC)

ZONING CONCEPT AT THE INCIDENT SITE

OSC

OMC

FFC

WORK PROCESS FOR APPLICATION FOR TEMPORARY PRACTISING CERTIFICATE MALAYSIA (TPC) FOR ARF DIREX 2015

STEP

PROCESS

ACTION

1

FILL UP TPC FORM ATTACH RELEVANT DOCUMENTS AS PER IN INSTRUCTION

DOWNLOAD FROM ARF DIREX WEBSITE-> Temporary practicing certificate

2

SEND ALL FORMS TO THE AFFECTED COUNTRY

SUBMIT ALL FORMS THROUGH ARF DIREX

3

MOFA WILL PROCESS THE APPLICATION

MOFA SEND THE FORMS TO THE MINISTRY OF HEALTH (DG/DEPUTY DG OF MEDICAL)

4

APPROVAL OF APPLICATION

THE DG/DEPUTY DG OF MEDICAL WILL VET THROUGH THE APPLICATION BEFORE CONSIDERING IT FOR APPROVAL

5

FEEDBACK OF APPLICATION

MOH WILL INFORM OF APPROVAL