KUALA LUMPUR, Feb 27 — The Malaysian Nurses Association (MNA) strongly opposes the relaxation of the academic entry requirement for nursing diplomas, warning that this could compromise the quality of health care services.
MNA IIUM Chapter chairman Prof Mohd Said Nurumal said the move to lower the requirement from five Sijil Pelajaran Malaysia (SPM) credits to three—introduced to address Malaysia’s ongoing nursing shortage—risks producing underqualified professionals at a time when health care is becoming increasingly complex.
“If we are facing a shortage of doctors, would we lower the requirements for medical school? If you agree to that, then I have nothing else to say,” Mohd Said said during an expert panel discussion at the Future Healthcare Asia 2025 conference here on February 18.
He criticised the government’s approach, arguing that instead of lowering standards, authorities should focus on making nursing a more attractive career through better salaries and career pathways.
“I feel personally unhappy because this is my profession, and the system has now allowed the requirement to drop from five credits to three.
“If I were part of the decision-making team, I would focus on making nursing a career of choice. People should want to be nurses because of the promising career pathways and opportunities available.
“So if it were me, instead of lowering the requirement, I would push for a strong scholarship programme and financial support. Give them a solid five-year career journey, and they will come to us.”
Malaysia’s nursing workforce has been struggling with high attrition rates, with many nurses leaving for better-paying jobs abroad in countries like Singapore, Australia, and the United Kingdom.
Mohd Said said the MNA had sent multiple letters to the Ministry of Health (MOH) questioning the decision. “The response we received from the Health director-general (DG) was ‘terdesak’ (desperate),” he said.
The change in entry requirements, applicable only to intakes in 2025 and 2026, has sparked concerns that Malaysia could end up with a three-tier system of nurses—degree holders, diploma holders, and those with even lower entry qualifications.
“By reducing the requirement to three credits—even though the letter states it’s only for 2025 and 2026—what happens next? Health care today is so advanced that it demands strong cognitive skills,” he said.
“If the MOH registers nurses who enter with three credits, will they develop into good communicators? Will they become critical thinkers?
“We already have a two-tier system—diploma and Bachelor of Nursing—both leading to registered nurses. We’re still discussing how to address this gap. But now, another group is being introduced with a lower entry point.
“We don’t understand why they chose this approach. If you ask me, there’s little we can do since they have already decided. They insist on doing this for two years, and we can only hope the results at the end of this period will prove otherwise.”
The Association of Private Hospitals Malaysia (APHM) and the Malaysian Medical Association (MMA) have also opposed lowering nursing diploma entry requirements, warning it could compromise health care standards.
APHM president Dr Kuljit Singh, who was the panel moderator, said he has been vocal in objecting to the decision, even as he has pushed for solutions to the nursing shortage.
MMA argued that instead of easing requirements, the government should improve salaries, working conditions, and career development to attract and retain nurses.
Health Minister Dzulkefly Ahmad has since defended the move, saying it would not affect training quality as the curriculum remains unchanged, with core subjects like Malay Language, Mathematics, and Science still required.
In a written parliamentary reply to Mas Gading MP Morsi Bimol last week, Dzulkefly added that the revision will not impact the international accreditation of Malaysia’s Diploma in Nursing programmes, as they continue to meet academic and training standards.
The policy took effect last month and is scheduled to end in December 2026.
Foreign Workers As A Solution?
While the MNA has opposed lowering nursing standards, others on the panel suggested a more immediate solution: hiring more foreign nurses.
APHM noted that while Malaysian nurses are leaving for better opportunities, foreign nurses—particularly from India—are still willing to work in Malaysia despite the pay gap.
“In India, there is an abundance of nurses. Many are eager to work here because salaries in Malaysia are still higher than in their home country, and our culture is more familiar to them,” Dr Kuljit said.
However, Mohd Said pointed out that bringing in foreign nurses is not a simple fix. “They still have to pass exams to practice here, and early results from the latest batches show that many have struggled to meet the required standards.”
Azrul Mohd Khalib, CEO of the Galen Centre for Health and Social Policy, went a step further, arguing that Malaysia has no choice but to recruit more foreign health care workers.
“I’m going to suggest something that is not popular: We need to bring in foreign health care workers. The fact is, we simply do not have enough doctors and nurses in the country.
“We have to do what other countries have done, which is to bring in manpower from other countries who may be willing to work in our hospitals, clinics, and so forth, to staff the positions that we don’t.
“Remember, there are 6,000 vacancies for doctors and 8,000 vacancies for nurses in the public health care system. No fantasy is going to fill up these positions,” Azrul said.
He added that Malaysia must also improve working conditions and pay for local health care workers. “We need to treat them with dignity and respect, and not overload them with excessive shifts.”
