The media headline of “Medical Officers May Never Get Permanent MOH Appointments” as reiterated by our Minister of Health on the 1st of November is something not unexpected, but still sends many doctors to be and junior doctors into a shock wave of uncertain future.
Faced with the reality and the fact that the Ministry of Health cannot indefinitely absorb the continual influx of 5,000 or more newly minted doctors every year, there will certainly be many doctors facing the prospect of no jobs after their compulsory service with the government.
It has been estimated that soon perhaps up to half of the annual turnover of doctors may have their contract not renewed or offered a permanent post after the two years of medical officers’ service, in which case they will need to look for jobs in the private sectors, universities etc, many may not really be doctoring jobs.
So why have we come about to such a mismatch of doctors supply and demand and more importantly, why is the situation getting worse rather than improving?
The answer to the glut is obvious as we are producing too many doctors too fast.
Looking at Malaysia with a population of 32 million, we have 34 medical schools at last count producing about 4 thousand doctors annually with more than 1,000 returning from overseas.
According to the department of statistics in 2017, the doctor to population ratio is 1: 554. Comparatively, looking at Australia and United Kingdom with a population of 25 and 67 million, the number of medical schools are 21 and 33 respectively.
Malaysia may have the highest number of medical schools per population ratio in the world!
The answer to the current glut is obvious and that is to curtail supply, but the political will power to do the needful is painfully challenging.
Along with this glut comes the issue of quality of training whereby there are not enough training slots, trainers and even patient load for many junior doctors to gain adequate skills and experience.
Although there is a quality assurance mechanism in place for medical schools and emphasis on acceptable standards, it’s very rare to hear any medical school closing down or even overseas medical schools being derecognised, raising the question whether we are serious in maintaining the standards required.
There are many other suggestions and proposals to solve the current glut, some are already being implemented such as a moratorium on new medical schools, increasing the quota for foreign intake by our local universities while other credible suggestions are being seriously considered.
The government meanwhile has also set up a medical officers placement committee to expedite their movement within the MOH after completing housemanship.
Ultimately in the end whatever is done or implemented, we will see a sizeable number of doctors who will eventually find themselves jobless, forced to then move into other industries totally unrelated, so as to earn a decent living, perhaps for the better and some for the worse.
There was a report that alluded the government is not obliged to ensure every doctor gets a job, its main priority being the provision of quality medical services. Unfortunately, the government is achieving neither.
In reality, it is the government who allowed the mushrooming of medical schools with its massive overproduction of doctors and now it is time for the government once and for all to do the much needed remedial actions and heal our health care so to speak.
What’s needed to be done is painfully obvious and with so many other well thought out proposals to the government all the time, there is no mystery as what can really make a difference and yield beneficial outcomes.
It not only morally right for the government to take this heavy responsibility for the sake of all the doctors and the public to do what’s right, but also there are no other choices lest we see total catastrophe to our health care system.
Dr John Teo is a consultant obstetrician and gynaecologist from Kota Kinabalu, Sabah.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.