Underpaid Doctors Rage Against Contract Medical Officer System

By CodeBlue | 12 November 2019

Medical officers are being paid less than housemen in the same pay grade.

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KUALA LUMPUR, Nov 11 – Junior doctors took to social media to vent their frustrations with the new contract system for medical officers, with some even talking about a strike.

They pointed out that contract medical officers — all of whom were continued on the UD41 civil service grade, unlike their permanent counterparts who were promoted to UD43/44 — actually earned even less than their juniors on the same pay grade, as house officers received an RM600 flexi allowance.

“We want UD43/44 salary. It’s just RM200 extra, MOH (Ministry of Health) was saying what’s the big deal. We are asking back the same thing now — what’s the big deal it’s just 200 bucks more. It shouldn’t bite your pocket.

“The UD43/44 grade comes with more benefit than UD41 — health claims, travel expenses etc,” said Dr S.S. Vikkineshwaran, the chairman of Malaysian Medics International (MMI), a group of doctors and medical students.

“UD43 doctors can prepare medical records for which we get extra allowance — RM75 per record. UD41 doctors cannot do medical record. This also results in the current UD43 doctors being overworked.”

MOH said last Friday that a UD41 officer’s monthly salary in the last year of their first housemanship contract could be RM3,397, noting that the difference with a UD44/43 officer was “not a lot”.

According to the Public Services Commission (PSC) website, the UD44/43 pay grade has a starting salary of RM3,611, with an RM250 annual increment. Contract UD41 medical officers are eligible for an annual increment of RM225.

Other doctors have also voiced their disgruntlement in the issues faced by doctors.

“Do you know why so many are reluctant to continue being doctors? On contract, but have to finish work as best as we can. But they don’t get privileges like permanent officers. Don’t get the same salary. But usually it’s the contract officers who work the hardest because they’re afraid of getting terminated,” a Dr Aen, who is now a makeup artist, posted on her Twitter account in Malay, which has since received almost 10,000 retweets.

She also pointed out that contract medical officers can’t pursue their Master’s to specialise because this is only open to those holding permanent posts for three years.

“Want to be specialist, have to take the alternative pathway with a lower salary, one paper is already thousands of ringgit. If fail, have to repeat and pay again,” she said.

Contract medical officers, she noted, can’t immediately quit after their housemanship either to be a permanent locum medical officer in a private clinic because of their mandatory two-year service with the government.

“You tell me macam mana these people nak kerja dengan ikhlas? You’re pushing them to the corner. You make them suffer physically and mentally w/o better option.”

Another Twitter user compared the situation with what happened in the UK in 2016, when junior doctors across England went on strike four times, each lasting 24 to 48 hours, to protest against the government’s proposed changes to their contract.

“This MO contract fiasco is not something new. Something similar happened to NHS in UK in 2015. Back then, the newly negotiated contract terms for junior doctors in UK were deemed unfair and unsafe. Did the junior doctors just accept the fact? No, they fought back,” said Twitter user @azmanrocks.

Doctors also posted their disappointment on MMI Doctors’ Facebook page.

“My concern – our future after 2 years of last contract, as MO. What if there’s no enough place for us to practice as a doctor if we’re not absorbed to permanent, even in military/hosp university/gp/private hosp as suggested. Then, what should we do after that? Otherwise, underpaid issue and losing our seniority due to contract basis,” Dr Amira Illyani Azhar Apendi posted on Facebook.

A Dr Wan Saidatul Sakinah posted on Facebook: “Not promised a permanent spot but still have to stay for 2 years compulsory service. If there’s no certainty, better just give the freedom of choice to us. We can’t further our studies, but we can’t exactly leave government. Unfair being the UD41 for five years.”

Doctors have to undergo training for two years in their housemanship, though they may be allowed to complete it in three years, after which they are required to serve the government as medical officers for two years.

“My biggest concern is that the contract system isn’t solving the problem. It is just delaying it,” posted Dr Mohammad Danial Azmi Sukri on the same platform.

“Securing a permanent pot for future doctors is the main issue but how about the fate of MOs (medical officers) who are re-offered a contract extension for 2 years but with no increment in allowance of grade promotion? Seriously to stay in UD41 for 5 years? Our scope of job is different compared to UD41 once we have become medical officers, I think this needs lengthy explanation,” added Nor Izhharuddin Zainy on Facebook as well.

“SKT has never been a fair measurement of competency due to the lack of transparency but opens up window for favoritism. Till date, no action has been taken on those frequent MIA/incompetent/problematic “permanent” officers,” posted Twitter user FentaPropoRoc, replying to CodeBlue’s tweet of an article about MOH’s announcement that it could no longer provide permanent posts to all medical officers.

SKT is the Sasaran Kerja Tahunan performance evaluation tool for government doctors, which is perceived by many doctors, as indicated in a recent survey in a Facebook group of doctors, to be opaque, and open to abuse and favouritism.

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