Contract Doctors’ Resignation Trend Rising, MOH To Cut Permanent Appointment Offers By 31% For 2024-2025

Contract medical officer resignations dropped 32% to 924 in 2023 from 1,354 in 2022, but overall resignation trend rose 2017-2023. MOH also plans a 31% reduction in doctors’ permanent appointments from 8,704 offered in 2022-2023 to over 6,000 in 2024-2025.

KUALA LUMPUR, March 25 — The number of contract medical officers who quit the public health service declined last year to 924 resignations, after a high of 1,354 resignations in 2022. 

Health Minister Dzulkefly Ahmad told Senator Dr RA Lingeshwaran in a written Dewan Negara reply last March 19 that 3,046 contract medical officers quit between 2021 and 2023.

“These resignations were because, among others, officers receiving job offers as public university lecturers, private sector work, personal reasons, and health reasons,” Dzulkefly said.

Although the number of contract medical officers who quit declined 32 per cent from 1,354 in 2022 to 924 in 2023, seven-year data from 2017 to 2023 shows an overall rising trend of resignations among contract doctors.

Dzulkefly also said MOH plans to offer more than 6,000 permanent appointments to medical officers from 2024 to 2025. This is a 31 per cent decline from the 8,704 permanent positions offered in the past two years from 2022 to 2023.

It is unclear why the government is reducing the number of permanent posts for doctors, especially when 20 per cent of the 5,489 medical officers offered permanent posts last year didn’t report for duty at their placements, or a whopping 1,118 doctors. 

The first big jump in contract medical officer resignations occurred in 2019 when 475 quit, up 183 per cent from 168 resignations in 2018.

The next spike occurred in 2022, post-pandemic, when a whopping 1,354 contract doctors resigned from public service, marking a 76 per cent increase from 768 resignations in 2021.

Last year was the first time that contract medical officer resignations declined, after five consecutive increases from 2018 to 2022.

It is also worth noting that the contract doctor workforce size has been increasing at smaller rates annually from 6,120 officers in 2017 to 32,813 officers in 2023, with yearly rates of increase slowing from 81 per cent in 2018 to just 11 per cent in 2023.

Or, to put in another way, the number of resignations rose 1,131 per cent from 110 in 2017 to 1,354 in 2022. But in the same period, the contract medical officer workforce expanded by just 383 per cent from 6,120 in 2017 to 29,548 in 2022.

In other words, the rate of resignations is nearly three times higher than the rate of expansion of the workforce.

So does 2023 show a turnaround point for contract doctors in Malaysia? Not necessarily – because of the rising trendline from 2017 to 2023, after the contract system for government health care professionals was introduced in 2016.

The clue to bad working conditions for government doctors remaining status quo lies in the number of medical officers who did not report for duty for permanent appointments in 2023, a proxy for resignations.

The number of medical officers who didn’t report for duty at their placements for permanent positions surged 1,333 per cent – within a single year – from 78 in 2022 to 1,118 in 2023. This attrition rate jumped from 2 per cent to 20 per cent of those offered permanent appointments.

If even permanent appointments – historically the biggest pull factor to retention in the public health service – are no longer an attractive prospect, then it is likely that contract doctors themselves aren’t extra motivated to stay in the workforce. 

The drop in contract medical officer resignations last year could simply be because so many of them already quit earlier in 2022.

MOH To Submit HLC’s Proposed Solutions To Cabinet

In a separate written parliamentary reply to Senator Low Kian Chuan last March 20, Dzulkefly said the High-Level Committee (HLC) had – in a meeting on October 25 last year that was chaired by his predecessor, Dr Zaliha Mustafa, and the Public Service Department (JPA) director-general – discussed proposed solutions on contract medical officer issues, including the production of medical graduates and job offers for medical practitioners in the private sector.

Previously, the HLC, which was formed nearly a year ago on March 31, 2023, held engagement sessions with the Association of Private Hospitals Malaysia (APHM), the Malaysian Medical Association (MMA), and the Malaysian Productivity Council (MPC). The HLC comprises JPA, the Ministry of Finance, the Ministry of Economy, and the Higher Education Ministry.

“The Ministry of Health is currently finalising initiatives and action plans under the committee for consideration and approval by the Cabinet,” Dzulkefly said.

Throughout the past one year after the formation of the HLC in March 2023, Dr Zaliha – who was health minister until she was replaced by Dzulkefly in a Cabinet reshuffle last December – did not provide any updates on the discussions or engagement sessions held by the HLC.

In the meantime, both contract doctors and those offered permanent positions have been quietly quitting the public health service in droves. 

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