When 293 out of 542 newly posted medical officers failed to report for duty in Sarawak, it was not a coincidence, not defiance, and not a clerical mishap — it was the system finally exposing itself.
The numbers did not collapse overnight; they reflect years of denial about how serious Malaysia’s doctor shortage has become, and how unattractive public service is compared to every alternative available.
Blaming the doctors or citing “failure to report” ignores the real issue: Malaysia no longer has enough doctors to supply its own hospitals, and those who remain will not uproot themselves for postings that offer low pay, high cost and no security.
The centralised deployment model has been treated like a logistics exercise — assign, announce, assume compliance. But Sarawak is not a spreadsheet cell, and doctors are not disposable inventory.
On paper, the state received hundreds of officers. In reality, more than half never came. That is not a posting glitch. That is a system that has lost credibility.
It is also misleading to act as though Peninsular Malaysia has spare doctors waiting to be shipped out. The shortage is nationwide. Sabah needs doctors. Johor needs doctors. Klang Valley needs doctors.
Every emergency department, medical ward and health clinic is struggling. The idea that 542 people could simply be “sent” to Sarawak assumes there were 542 to begin with — there weren’t.
And the biggest truth of all: many of those who were posted have already left the service or the country. They have taken up jobs in Singapore, Australia, Brunei, the United Kingdom, New Zealand, and the Middle East.
They have joined private hospitals, locum networks, or non-clinical sectors. They have gone where the pay is higher, the hours are safer, and the career path is certain. When the public system cannot retain its own workforce, posting letters are just paper.
Sarawak’s leaders have every right to be angry, but they should not be surprised. The state requested 650 doctors and is still short by more than 1,000. To meet basic ratios, it would need at least 2,500 more. But posting alone will not deliver them, because the postings come without the one thing that actually moves people: incentive.
Doctors will only transfer if the offer is better than what they have, not worse. That means:
- A 60 per cent to 70 per cent salary increase, not the same Ministry of Health (MOH) base pay.
- Housing allowances and relocation support.
- Financial coverage to move spouses and children.
- Insurance, emergency evacuation and flights home.
- Guaranteed specialist training pathways.
- Removal of immigration barriers like the “blue passport” requirement.
Anything less, and the state will keep losing to Singapore, Australia, Brunei, and even private hospitals in Kuala Lumpur. Sarawak cannot demand manpower and offer nothing extra.
Every doctor knows that once they cross the South China Sea, their workload goes up, their cost of living rises, and their career progression becomes uncertain unless the state intervenes.
The federal system also needs to take responsibility. It has enforced a one-size-fits-all deployment model designed for Klang Valley and applied it to the largest and most logistically complex region in the country.
There is no rapid replacement mechanism, no real-time accountability, no support structure and no retention strategy. The ministry treats large-scale absenteeism as routine instead of recognising it as systemic collapse.
This is not about personal discipline or “duty reporting.” When more than half of assigned personnel do not arrive, the system has not been ignored — it has been rejected.
The message is clear:
If Sarawak wants people to show up, it has to pay, protect, and support them.
If the federal government wants postings to work, it has to fix the incentive gap or devolve the authority to those who understand the terrain.
If policymakers want to stop the exodus, they have to match what other countries are offering — not hope that patriotism will outweigh payroll.
The question now is whether Sarawak will just issue statements, or finally put money and policy behind its demands.
Without real investment, this same story will repeat itself with new numbers, new headlines and the same outcome: empty wards, burnt-out staff and letters of appointment that lead nowhere.
The 293 no-shows were not the problem. They were the diagnosis.
The author is a medical officer at a public hospital in the Klang Valley. CodeBlue is giving the author anonymity because civil servants are prohibited from writing to the press.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
