MALAYSIA currently has about 5,000 new medical graduates yearly. Since 2016, these junior doctors have been offered two-year housemanship contracts followed by a subsequent two-year medical officer contract. Those returning from overseas after completion of their housemanship were only given the medical officer contracts. The contract system is one of service and does not have an avenue for continuation, nor extension to allow for specialization and further training. Only less than 15% of the contract medical officers have been offered permanent positions, and as such, should nothing be done, almost 4,000 medical officers will lose their positions within the government service by May 2022. This, to us, constitutes a crisis in human resource management.

For our junior alumni, we have identified the following challenges as well as its impact to the healthcare ecosystem of the country.

1. Lost future of healthcare – the 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 only open to permanently employed staff. The 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 for the junior doctors to continue their training as specialists. The ideal mechanism would be to increase the number of permanent positions to match the population needs. This would allow for less changes that needs 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 future of healthcare in the country is safeguarded and the expansion of the services can be expanded, thereby improving access to specialist care in Malaysia.

2. Inequality of the system

Problem statement

The current contract system does not follow with the career progression pathway of the permanent system. The new contract officers have all been offered a lower grade despite their increased responsibilities. In the recent offers, even the permanent officers were offered UD41 instead of UD44.

Proposed solution

We thank the government for moving towards this harmonisation, and hope that this issue be laid to rest by ensuring that all career pathways planned in the future will continue to follow the established time based promotions.

3. Transparency of the selection for permanent positions

Problem statement

The selection criteria for permanent positions have not been clearly informed to all the contract officers. At the current moment the selection process is shrouded in mystery with only the most general of outlines shared with the junior doctors. This has created confusion as well as a lot of distress for the junior doctors as they are unsure of their futures and how they will attain some security in their careers.

Proposed solution

We hope that the Health Ministry could make available the selection criteria for these permanent positions as well as to share the ranking system that is being used to select the candidates for permanent positions. We also urge the ministry to ensure that the process is fair for 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 the healthcare services that were already overworked, understaffed and overstretched. We hope that the sacrifices and services of the doctors and other healthcare workers, more so the junior doctors, will be remembered and rewarded justly.

Mutual consent by:

• The Malaysian Medical Association (MMA)
• Persatuan Alumni Doktor USM (PADU)
• University of Malaya Medical Alumni Association (UMMAA)
• Alumni of Medical Doctors IIUM (MEDIIUM)
• Manipal Alumni Association Malaysia
• Alumni Association of International Medical University
• Alumni Perubatan dan Kejururawatan Unimas
• AIMST University Medical School Alumni Association (AMSAA)
• Persatuan Doktor Perubatan Universiti Kebangsaan Malaysia
• Medical Doctor Alumni Association of UMS (MEDAUMS) – November 26, 2020.

* 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.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.