Teaching Chiropractic on the Other Side of the World, Part 1

After only two years, the chiropractic program at Malaysia's International Medical University is thriving.

By George Le Beau, DC

There are two official languages in Malaysia: Bahasa Malaysia and English.

Universities that have the term international in their title are "English first" educational institutions, which means all classes are taught in English. International Medical University (IMU) is the largest privately held medical university in Malaysia and offers programs in medicine, dentistry, nursing, pharmacology, psychology, biomedical science, biotechnology, Chinese medicine, nutrition and dietetics – and most recently, chiropractic. Currently there are about 35 chiropractors in the entire country. The recent growth of the chiropractic profession and chiropractic education in Malaysia is nothing short of phenomenal.

About eight years ago, IMU's Board of Directors approved an international study on future direction of health care trends. Not surprisingly, they found a growing number of the population turning to alternative health delivery systems, rather than traditional Western medicine. Chief among the findings was the attraction to and worldwide growth of chiropractic medicine.

Shortly after the findings were presented to the IMU board, it set out to develop the first chiropractic program in Southeast Asia. Initially, resistance from the Asian medical community was intense. Fortunately, the president of IMU, Tan Sri Dr. Abu Bakar Suleiman, former director general of the Ministry of Health (1991-2001), had the vision and strength to pursue chiropractic medicine as an important component of public health and IMU education.

In 2008, IMU hired Dr. Michael Haneline, previously of Palmer Chiropractic College West, as head of the chiropractic program. With the help of Dr. Philip Ebrall of RMIT Chiropractic College in Australia, Dr. Haneline completed the final proposal of IMU's chiropractic curriculum, which was submitted to the Malaysian Qualifications Agency, and soon accepted and approved. The chiropractic program commenced in February 2010.

Much of the chiropractic curriculum was developed in coordination with the RMIT Chiropractic College of Australia, which is one of IMU's many partner universities. Once the curriculum development process was set in motion, Dr. Haneline advertised for chiropractic educators in several journals and publications. One of IMU's advertisements in Dynamic Chiropractic got my attention and that of my good friend, Dr. Rand Baird, a former professor at Southern California University of Health Sciences.

I have been a chiropractor for 40 years, and had a practice in Carlsbad, Calif. Dr. Baird and I responded to the advertisement and were invited to interview with IMU. We made our first trip to Malaysia in July 2009. The interview went well and I was offered a position as clinic director of the soon-to-be-built chiropractic health center. [Dr. Baird, a longtime DC columnist, helped coordinate the chiropractic program at IMU and is currently a professor for the program.]

After several months of negotiation, I accepted the offer and started work at IMU in March 2010. I was anxious to commence patient care, but with no office or health center, I was limited to borrowing a table from the student skills center, an open-bay teaching lab with 16 stationary tables for students to practice technique skills.

On my first day, I treated one patient, a female with a frozen shoulder problem. Because the Ministry of Health had not yet licensed IMU's chiropractic health center, I was temporarily restricted to treating IMU employees, staff and students. The introductory rate for chiropractic care was RM 50, about US$15.

International Medical University (IMU) in Kuala Lumpur, Malaysia, welcomed its inaugural chiropractic class in early 2010. While waiting for the build-out of the health center, I met with the center director and negotiated a new floor plan. I explained that the current plan was too squared-off and did not accommodate smooth patient flow. He asked if I could show him what I meant, and I drew an entirely different floor plan. When I showed it to him, he brought in the contractor and instructed him, "This is what we are now building." The contractor asked a few questions about electrical and plumbing, and then said, "OK." The center encompasses approximately 5,000 square feet of space and currently has eight treatment rooms and two consultation and examination rooms, with plenty of room for expansion.

By the end of March 2010, I was treating 10-15 patients a day in the skills center and had moved to a small private room attached to the dental clinic with two tables. The facilities manager put up a couple of partitions and I was in business. Several of the chiropractic students volunteered to help me in the temporary health center and by early May 2010, I was treating 30 patients a day.

Within two months of my arrival in Malaysia, the chiropractic health center had been constructed and fully equipped, and we had our grand opening on May 15, 2010. The contractor, procurement department, human-relations personnel, and new staff all worked together and did a remarkable job getting the chiropractic health center up and running.

The IMU chiropractic center has now been open for more than 16 months, and within the first full year, we were consistently seeing an average of 100 new patients a month. The demographics of chiropractic patients are heavily tilted toward the Chinese population here in Malaysia. Although Chinese Malaysians make up about 25 percent of the total population, chiropractic patients are approximately 80 percent Chinese, 10 percent Indian and 5 percent ethnic Malaysian, with the remainder expats working here from numerous countries.

Anna Maria Jorgensen, DC, PhD, from Denmark, was the first associate chiropractor who started in October 2010. The first expansion of the health center began soon after her arrival, and two more treatment rooms and one examination room were added on the other side of the reception desk. Dr. Jorgensen worked in this area, which came to be known as the "Anna zone." Not long after the chiropractic health center was constructed, IMU built and opened the Chinese medicine center. This is adjacent to and in direct contact with the chiropractic center, and we share the reception room.

Staff of the chiropractic health center at IMU; Dr. George Le Beau, clinic director, is front row, middle. Our clinical staff now consists of one medical supervisor, three chiropractors, eight chiropractic assistants (six full time and two part time), one chiropractic / Chinese medicine assistant, an office manager, a marketing director and a receptionist/cashier.

The chiropractic program at IMU was popular and grew faster than anticipated. Based on the university's experience with its other schools, they anticipated 10-15 chiropractic students entering in the first class and perhaps 20-25 chiropractic students entering in the second class. Much to the university's surprise, the first chiropractic class that started in February 2010 had 30 students, twice as many as anticipated.

Because we did not have enough teaching chiropractors, Dr. Jorgensen and I were called to assist in teaching the academic program. Although this was planned from the beginning, the extent of our teaching duties increased, and I was now teaching 10-20 percent of my time and Dr. Jorgensen, who had more teaching experience, was teaching 80 percent of her time and seeing patients in the health center 20 percent of her time. This was necessary because the second class of chiropractic students started with 45 students, a 50 percent growth in one year. Now we had 75 students and three full-time chiropractic faculty members.

IMU has since hired two more chiropractors, but before they arrived, it was decided to begin the second expansion of the health center, which is in the final stages of completion and now has 13 treatment rooms. The two new doctors who started in September 2011 are Dr. Kumaran Pilley, a South African and graduate from Durban University of Technology; and Dr. Omar Pervez, a Canadian and graduate of the University of Western States.

IMU's chiropractic program is four years of undergraduate training with an additional year of "housemanship," for a total of five years. The current student ratio of females to males is almost 1:1, with slightly more female students. The students are roughly 80 percent Chinese, 10 percent Malay and 10 percent Indian. Although IMU's DC program has no foreign enrollment now, foreign students are welcome and may apply. The average age of chiropractic students is 19 years.

In Malaysia and many parts of Asia, most students finish high school at age 15 or 16, and by the time they make a decision to attend a professional school, almost all have completed at least two years of college. It is not unusual for a young student to attend classes all day, go home to change their book bag, and then head to evening/night school. On weekends, they attend weekend school. In addition to these are extra language school classes, especially English, and studies in music, dance and art. Usually they get a half-day off, on Sunday, to attend church. It is a life full of study. I must say that the students at IMU are the most dedicated, hardworking and respectful young people with whom I have ever worked.

IMU has twinning programs with more than 30 partner medical schools around the world, including top medical schools in the United Kingdom, Australia, New Zealand, and Canada, as well as Jefferson Medical College in Philadelphia. IMU's chiropractic program affiliates with RMIT Chiropractic of Australia and the Anglo-European College of Chiropractic in the UK.

IMU admits one cohort of chiropractic students a year each February. The latest cohort of 60 or more students brings the total number to more than 130 students in three years. By the time the first cohort graduates in 2015, total enrollment is expected to be close to 300 students.

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Quick Facts About Malaysia

• Malaysia is literally on the other side of the world from the U.S. The time difference between Malaysia and Texas is 12 hours, and a flight from California to Kuala Lumpur, the capital of Malaysia, takes about 17 hours. That means you eat a couple of meals, take a five-hour nap, and then you are halfway there!
• Malaysia is a country of roughly 26 million people located between the South China Sea and Indian Ocean. To the north is Thailand and to the south is Indonesia, and further south is Australia. The government is an elective constitutional monarchy, similar to, but not quite the same as the United Kingdom. The population is 67 percent ethnic Malay, 25 percent Chinese, and 7 percent Indian; the remaining 1 percent are foreigners from every conceivable country.
• The main religion is Islam, followed by Buddhism, Christian religions, and Hinduism. Although the constitution recognizes Islam as the state religion, it also guarantees freedom of religion, which can be seen in virtually every part of the country in the diversity of mosques, temples and various Christian churches. One of the most surprising things for me to witness as a recent arrival was the all-out celebration of Christmas in every mall, store, park and meeting center in the country. The Christmas displays, including fully detailed manger scenes, are nothing short of spectacular.
• Kuala Lumpur (KL) has a population of 1.5 million. With its freeway system, modern downtown and traffic, it reminds me of Los Angeles. The biggest difference is that KL has a highly functioning and fully utilized commuter train, subway system and monorail. Like many of the former British colonies, cars drive on the left side of the road. I was surprised at how easy it was to get used to driving on the left.
• Malaysia is immediately north of the equator and the average annual temperature is about 85 degrees F. Humidity is in the 80-90 percent range and average annual rainfall is about 100 inches. If you like the heat, as I do, you will love Malaysia.
• The economy of Malaysia has been growing steadily and consistently for over 50 years. The latest figures (2010) show an annual economic growth rate of 11-12 percent. The employee retirement fund is currently earning 5.8 percent per year. The Malaysian Ringgit is about 3 to 1 compared to the U.S. dollar, and the cost of living in KL is comparatively inexpensive. It is well within reason to have a very nice three-bedroom condo for about US$900 per month. Food and clothing are also very reasonable, as is public transportation.

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Author's Note: Special thanks to Michael Hubka, DC, FCCS(c), Associate Professor, Faculty of Medicine at IMU, who contributed substantially to the content of this article.

Part 2 of this article appears in the March 26, 2012 issue of DC.

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Dr. George Le Beau is an associate professor in the chiropractic program at International Medical University and directs the university's chiropractic clinic. He can be contacted with questions and comments via e-mail: .