Malaysia faces losing future medical specialists as training barriers persist, with the MMA warning of worsening patient care and more doctors heading overseas.
PETALING JAYA: Malaysia risks driving away future medical specialists at a time when the country is facing a shortage of almost 11,000 specialists, with the Malaysian Medical Association (MMA) warning that delays and barriers in subspecialty training could worsen patient care and encourage more doctors to seek opportunities overseas.
MMA president Datuk Dr Thirunavukarasu Rajoo said every delay in producing subspecialists would ultimately affect patients who depend on the public healthcare system, where seven out of 10 Malaysians receive treatment.
“When we lose a subspecialist, it is the public patient who pays the price through longer waiting times, delayed treatment and reduced access to specialised care,” he said in a statement.
The warning comes amid growing concerns over eligibility requirements for doctors applying for subspecialty training in areas such as cardiology, oncology, gastroenterology and neonatology.
While the Health Ministry (MOH) oversees the country’s subspecialty training programmes, eligibility criteria and Annual Performance Appraisal Report (LNPT) requirements fall under the Public Service Department (JPA), creating what the MMA described as a disconnect between workforce planning and the rules governing specialist progression.
According to Thirunavukarasu, the association recently raised the issue with senior ministry officials but decided to speak publicly because specialists and patients could no longer afford continued uncertainty.
One major concern involves changes to the LNPT requirements for the 2026/2027 intake. Previously, the best three appraisals within a five-year period were considered, but the criteria have reportedly been revised to require three consecutive years of appraisals.
Thirunavukarasu said such changes should be clearly communicated and implemented with adequate notice to avoid disadvantaging eligible candidates.
He also highlighted difficulties faced by doctors undergoing recognised Master’s training programmes.
Although these doctors continue treating patients while pursuing further qualifications, their training years are often recorded as cuti belajar (study leave), resulting in gaps in their performance appraisal records.
“A doctor should not be penalised for undertaking government-recognised training while continuing to serve in the public healthcare system.
“The same government that sponsors and recognises the training should also recognise the service provided during that period,” he said.
Thirunavukarasu stressed that the issue extends beyond workforce management and has direct implications for patient care.
He added that under the current system, doctors may take more than 15 years to progress from house officers to subspecialists, meaning additional delays reduce the number of years they can serve as highly trained specialists in public healthcare.
“Every delayed subspecialist means one less future cardiologist, oncologist, gastroenterologist or neonatologist available to serve patients,” he said.
The MMA president also expressed concern over the lack of transparency in the selection process, noting that unsuccessful applicants are often informed only that they were “Tidak Berjaya” (unsuccessful) without being given any explanation.
“Decisions that affect careers and ultimately the country’s future specialist workforce should be transparent,” he said, adding that written reasons and a formal appeals mechanism should be introduced.
To address the issue, the MMA called for clear written clarification of eligibility requirements, recognition of service performed during approved training years, standardised requirements across recognised pathways and greater emphasis on competency-based selection.
The association also urged policymakers to ensure stability and predictability in selection criteria, while continuing to factor Sabah and Sarawak into long-term workforce planning.
Thirunavukarasu said solving the problem would not require another task force, but rather closer coordination between MOH, JPA and the Higher Education Ministry.
“Malaysia needs more subspecialists, not fewer.
“A specialist blocked at home is a specialist recruited abroad. And the patient left behind is in a public hospital,” he said.
