I’m a specialist doctor working at a public tertiary centre in the Klang Valley. Despite close to three years after completing gazettement, I have yet to obtain registration on the National Specialist Register (NSR) as my head of department refuses to sign my application.
She says there are more seniors without NSR in the government sector and she is worried that I will leave the Ministry of Health (MOH) after getting NSR as many of my seniors have done.
Historically, the process for obtaining specialist registration in Malaysia has been lengthy and often cumbersome, with medical professionals required to navigate various steps. First, they must obtain approval for their qualifications, which may include both local and international certifications. Once their qualifications are assessed and verified by the Malaysian Medical Council (MMC), specialists are required to undergo a period of gazettement.
The gazettement period involves the formal process where the individual’s qualifications and credentials are published in the government gazette. This step is crucial for ensuring that specialists are recognised by the government as qualified professionals capable of practising in their respective fields.
The gazettement process often takes at least six months, leading to delays in the ability of specialists to begin clinical practice.
Subsequent to that, one has to submit another set of documents to apply for specialist registration i.e. NSR, whereby certain specialties have stricter requirements and need to produce a new logbook, whereas others have a more lenient system in place. Even the duration after which one can apply for NSR registration is not standardised.
For example, clinical specialties can apply after one year of practice (including gazettement period), whereas non-clinical have to wait for two years before applying for NSR (this is ironic as all specialties are indeed clinical.)
Another waiting period for review and assessment will ensue before NSR accreditation is finally given. A medical doctor who has completed four to five years of training – while making a lot of sacrifices in terms of personal care and family welfare – has to wait for at least another two years before being finally recognised as a specialist.
In many training centres, registrars, i.e. 3rd or 4th year master students, are already functional as specialists. Thus, this makes us ponder why qualified specialists who have undergone wholesome training have to be put through many assessments and supervision before finally being recognised as specialists.
In my opinion, it’s solely bureaucratic so that more control is exerted onto these new specialists so that they comply to the needs of the heads of department and heads of service. Many specialists in MOH hospitals who have successfully completed gazettement and worked many years as specialists are still not registered as specialists on the NSR.
Newer and more complex requirements are added to gazettement logbook and NSR, rendering it more difficult for them to get accredited as specialists. The new specialists are entirely at the mercy of the heads of department or heads of service to get their much-earned recognition as a specialist.
The reason why we are not hearing much about this is entirely because they are paid a specialist allowance since they start gazettement.
The newly proposed Supervised Work Experience (SWE) system, which seeks to replace the existing gazettement system, is a much welcomed effort by the MOH to expedite specialist registration in Malaysia. Now, let us dive deeper into this new system.
The overall process of gazetting and acquiring NSR is synchronised. Supposedly, the newly minted specialist can get NSR within one and a half years after finishing his/her training.
However, there are a few complicated things in this proposed system. A new logbook is introduced i.e. e-warta, which is a killer in my opinion. If any of the logbook requirements cannot be fulfilled, the e-warta cannot be submitted.
Knowing how services are randomly distributed in Malaysia, how does the MOH expect the specialist to complete the logbook requirement when working in a less equipped district or minor hospital?
Another striking difference is the lack of a specialist allowance. How can one expect a medical doctor to carry the responsibility of a specialist without being compensated fairly enough? What is the point of going through horrendous training as a Master student to get treated as such?
Is MOH indirectly asking new specialists to do charity? After specialists get their NSR, does the MOH then give them the option of resigning from the MOH workforce and joining the private sector as it is much easier to earn back their backdated allowance within one month of working there?
Expediting specialist registration is expected to have a profound impact on Malaysia’s health care system. The shortened waiting period for specialist registration will help reduce the bottleneck of qualified specialists waiting to enter the workforce. This will ultimately result in better patient care, particularly in areas where there is a shortage of specialists.
The push for expediting specialist registration represents a crucial step forward for Malaysia’s health care system. These reforms not only benefit medical professionals seeking to establish their careers, but also have the potential to improve patient outcomes by ensuring that skilled specialists are available to deliver timely, high quality health care services.
However, the registration has to more transparent and specialists have to be adequately compensated for their services. Otherwise, we risk losing some of the greatest treasures to our health care system.
Not only that, specialist registration for previously gazetted specialists must also be reviewed to ensure fair registration of specialists who have been serving in the MOH thus far.
CodeBlue is giving the author anonymity because civil servants are prohibited from writing to the press. Editor’s note: Prior to the publication of this article, CodeBlue reached out to MOH for a statement on two documents by the ministry’s Medical Development Division: “From Current Gazettement to New Supervised Work Experience and E-Warta” (a 26-page document dated October 29, 2024) and “Placement & Gazettement As A Specialist in MOH Malaysia” (a 26-page document dated February 4, 2025). CodeBlue has sighted both documents.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
