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MALAYSIA has about 5,000 new medical graduates annually.
Since 2016, these junior doctors have been offered a two-year housemanship contract, followed by a two-year medical officer contract. Those returning from overseas upon completion of their housemanship were only given the medical officer contract.
The contract system is one of service, and does not have an avenue for continuation, nor extension to allow for specialisation and further training. Fewer than 15% of contract medical officers have been offered permanent positions. Should nothing be done about this, almost 4,000 medical officers will lose their positions within the government service by May 2022.
This, to us, constitutes a crisis in human resources management.
For our junior alumni, we have identified the following challenges, as well as their impact on the country’s healthcare ecosystem.
Lost future of healthcare – lack of a clear career pathway
Problem statement
The current contract system, as mentioned above, has no avenue for a doctor to pursue specialist training, due to its short duration and service-oriented nature. All opportunities for specialisation are open only to permanent staff.
Junior doctors are the future of our healthcare system, and without continuity in the training process, we may see a shortage of specialists in the next 10 years.
Proposed solution
We urge the government to look into a mechanism to allow junior doctors to continue their training as specialists. The ideal mechanism would be to increase the number of permanent positions to match the population’s needs. This allows for fewer changes to have to be made to the existing specialisation pathway.
The second mechanism that has been suggested is for an extended contract of at least 10 years to cover training, specialisation and registration with the National Specialist Registry. In doing so, the government will ensure the country’s healthcare is safeguarded and services can be expanded, thereby improving access to specialist care in Malaysia.
Inequality of the system
Problem statement
The current contract system does not follow with the career progression pathway of the permanent system. New contract officers have all been offered a lower grade despite their increased responsibilities. In the recent offers, even permanent officers were offered UD41 instead of UD44.
Proposed solution
We thank the government for moving towards this harmonisation, and hope that this issue can be laid to rest by ensuring that all career pathways planned in the future continue to follow established time-based promotions.
Transparency of selection for permanent positions
Problem statement
The selection criteria for permanent positions have not been clearly informed to all contract officers. Currently, the selection process is shrouded in mystery, with only the most general of outlines shared with junior doctors.
This has created confusion, as well as a lot of distress, for junior doctors, as they are unsure of their future and how will they attain some security in their careers.
Proposed solution
We hope that the Health Ministry can make available the selection criteria for these permanent positions, as well as share the ranking system that is being used to select candidates for permanent positions. We also urge the ministry to ensure that the process is fair to all junior doctors, allowing those who are the keenest to remain within the government service.
There has never been a greater need for a robust and motivated healthcare workforce. The pandemic we face is challenging not only due to its virulence, but also its effect on healthcare services that were already overworked, understaffed and overstretched.
We hope that the sacrifices and services of doctors and other healthcare workers, more so junior doctors, are remembered and justly rewarded. – The Vibes, November 26, 2020
Joint statement by:
– Malaysian Medical Association;
– Persatuan Alumni Doktor USM;
– University of Malaya Medical Alumni Association;
– Alumni of Medical Doctors IIUM;
– Manipal Alumni Association Malaysia;
– Alumni Association of International Medical University;
– Alumni Perubatan dan Kejururawatan Unimas;
– AIMST University Medical School Alumni Association;
– Persatuan Doktor Perubatan Universiti Kebangsaan Malaysia; and,
– Medical Doctor Alumni Association of UMS.
* Disclaimer: The statement above is the stand taken by the various medical alumni associations, and does not reflect the official positions of the various medical universities
