The influence of the Royal College of Surgeons in Ireland is already felt around the world. Through both its multicultural alumni and its provision of teaching courses and examinations abroad, the RCSI is a major force in its field.

Last year, however, it strengthened that influence with the opening of the Penang Medical College (PMC) in Malaysia. A collaborative initiative between the RCSI, UCD and state agency the Penang Development Corporation, the initiative enables students from Malaysia to do their preclinical training in Ireland before returning home for clinical or hospital-based studies.

Officially opened last May, the PMC is a comprehensive clinical school of medicine with five major academic departments -- medicine, surgery, obstetrics and gynaecology, psychiatry, and paediatrics. It provides 40,000 square feet of lecture theatres, library, clinical skills facilities and tutorial rooms, as well as accommodation for academic departments. Its dean is Professor Tom Hennessy, a graduate of UCD, a former president of the RCSI and a former regius professor of surgery at TCD.

Malaysian students studying medicine in Ireland at both the RCSI and UCD bring in the region of £15 million to the Irish economy each year.

PMC students graduate with a degree from either RCSI or UCD, depending on the college to which they are originally attached. Their qualification is the same as if they had done all their training in Ireland.

This means that, if they wish to specialise, they have the advantage of an Irish qualification which provides for better opportunities in Britain, the US and elsewhere, according to Prof Hennessy. As well as costing them less money, splitting their time between Ireland and Malaysia also means they get more experience of the spectrum of disease where they will be working, he points out.

It's a novel approach to medical education, and it arose from the urgent need for additional doctors in Malaysia. Currently the ratio of doctors to population is 1:2,100.

The Malaysian government's target is to reduce this to 1:800 by the year 2020: "There is a shortage of doctors in the country and the bulk of these are concentrated in urban areas, leading to even greater shortages in rural areas," says Prof Hennessy. "The reason for the twinning arrangement is that it makes sense to do their pre-clinical training in Dublin, as this requires a lot of expensive laboratory facilities that would be very costly to try and establish in Malaysia."

The RCSI has, in the past, forged strong training links with other countries, specifically in the Middle East. The Ministry of Health in Bahrain and RCSI signed a Health Services Training and Co-operation Agreement in 1996, for example, which provides for a number of academic initiatives, including a health services management programme.

Moreover, a family practice residency programme is organised jointly by the RCSI and the Irish College of General Practitioners. This is a four-year training programme with annual assessments leading to a qualification awarded jointly by the Ministry of Health Bahrain, RCSI and the Irish College of General Practitioners.

However, the PMC is the first instance in which the RCSI has engaged in physically establishing a school. The college has been legally established as a company with equity divided between the RCSI, UCD and the Penang Development Corporation.

It is unique among twinning arrangements in that UCD and the RCSI have between them invested about 30 per cent of the total equity. This investment serves to reassure students about the Irish colleges' commitment to the project, the professor points out.

`WE now hope to expand into paramedical areas, such as physiotherapy and occupational therapy in the college, to build up medical services in Penang generally," he says. At present some 90 students are enrolled at PMC with the first crop of graduates emerging in June 2001. The college will ultimately cater for up to 300 students.

The RCSI has traditionally attracted many medical students from Malaysia, both because of the quality of its teaching and because such students find Ireland a good place to study generally.

"Both UCD and particularly the RCSI have a great mix of foreign students, among which is a very significant Asian section," says Prof Hennessy. "They tend to feel quite at home here. If you ask any of our Malaysian students they will tell you that Ireland is a pleasant place to live - apart from the cold climate, that is."

Although it must pay its way as a commercial enterprise, PMC was set up as a not-for-profit organisation, something which the dean strongly supports. "We in the RCSI have been in the education business for more than 200 years," he says. "It's what we are there for, and what we do. In the latter half of those 200 years we have always had a high mix of foreign students and this is just a further expression of our altruistic, educational philosophy."