Judge Dredd from the British comic 2000AD and played by Sylvester Stallone in the 1995 film adaptation declared: “I never broke the law; I am the law!”
The infamous quote by the anti-hero, who metes out instant justice to criminals in a dystopian world, reflects the Malaysian Medical Council’s (MMC) position in dealing with a backlog of 2026 annual practising certificate (APC) applications involving about 14,000 doctors across the public and private sectors as of December 31, 2025. These comprised a whopping 16 per cent of nearly 84,000 applications submitted.
Instead of upholding the Medical Act 1971 in the interest of patients, the MMC chose to protect the medical profession by simply waiving the statutory requirement for a registered medical practitioner to have a valid APC to practise medicine.
Lawyers say the Medical Act does not authorise MMC to grant its APC “waiver”, and that practising medicine without a valid and current certificate remains a criminal offence.
MMC’s attempt to become a law unto itself is supported by many members of the medical fraternity, though not all.
The Private Medical Practitioners’ Association of Selangor and Kuala Lumpur (PMPASKL) and Association of Private Practitioners Sabah (APPS) stand out for their courage in abiding by the law, while other doctors’ groups use MMC’s waiver to justify unlicensed practice of medicine for the sake of patient care.
In a remark on Facebook, the CEO of a private hospital operator told critics not to be “so sticky” about following the law, defending the MMC’s waiver as a continuation of life-saving procedures for patients.
Separately, private hospital operator IHH Healthcare Malaysia and Universiti Malaya Medical Centre (UMMC) have permitted their practitioners to practise pending APC issuance, while stressing that their hospitals maintain high standards and safety in ensuring continuity of care.
Section 20(7) of the Medical Act not only prohibits medical practitioners from practising medicine in general without an APC in force, but also specifically surgery and obstetrics and gynaecology (O&G).
The drafters of the law obviously believed that people should not be cutting up other people or delivering babies unless they’re trained – and licensed – to perform such high-risk procedures.
Doctors may think that they’re good at what they do—until something happens. The insurance industry has been tight-fisted in recent years to the extent of interfering with doctors’ clinical decisions, as reported extensively by CodeBlue.
The Life Insurance Association of Malaysia (LIAM) has already warned that a prolonged APC delay may create issues with guarantee letters (GL) due to compliance concerns. Insurance companies would be on the right side of the law if they denied GLs or medical claims for an illegal activity.
Problems with APC renewal have persisted for years, as attested to by individual doctors and health care providers, but the huge backlog of nearly 14,000 applications for 2026 is exceptional. It appears that MMC’s inefficiency in processing the one crucial document for doctors to legally practise medicine has been normalised.
Malaysia’s health care system is supposed to be among the best in the world, yet no other country permits medical practitioners to practise without a licence due to administrative delays.
2026 is Malaysia Year of Medical Tourism. Malaysia may suffer an irreparable hit to its reputation as the world’s “preferred” medical tourism destination if the government allows unlicensed surgeons in private hospitals to treat foreign patients.
Prime Minister Anwar Ibrahim recently reminded enforcement agencies to adhere to rules. Although his remarks were targeted at the police, among other bodies, the PM’s message can apply to MMC and the Ministry of Health (MOH) as well.
Health Minister Dzulkefly Ahmad should have heeded the prime minister’s advice, instead of getting other regulatory agencies within the MOH to support the MMC’s likely unlawful actions.
The MMC announced that it approved over 10,000 backlogged APC applications in the first eight days of the year, leaving 3,515 outstanding applications as of January 8 due to the need for further information from applicants.
If the regulator had maintained that practitioners cannot practise pending issuance of their certificate, as per the Medical Act, disruptions to health care services from 14,000 doctors stopping work from January 1 would likely last for weeks.
During this time, urgent cases can be referred to whichever doctor with a valid APC, across the public and private sectors. If no licensed doctors for a particular specialty are available in Malaysia or if departments are just too understaffed, send patients to Singapore. If the APC delay affects many emergency doctors, restrict emergency units to only critical cases.
For private practitioners facing a forced work stoppage, compensation should be provided for each day of lost income.
All of these costs should be borne by the MMC that made RM4.4 million profit in 2024, according to its annual report. If MMC doesn’t have enough money, then the government (i.e. taxpayers) can step in.
Let’s be clear: major disruptions and delays are unavoidable because of the MMC’s massive failure. There will be lots of pain all around. However, efforts to minimise disruptions to health care services should not come at the expense of patient safety and compliance with the law.
The Medical Act prohibits the practice of medicine without a valid APC to protect patients, so that even if they didn’t know what an APC was, regulators would ensure that penalties were severe enough to dissuade quack doctors.
The reason the Medical Act expressly prohibits medical practitioners from charging fees for services rendered during the period without a valid APC, beyond just practising medicine, is precisely to prevent profiting from unlicensed health care services.
Last year, medical practitioners protested loudly against a drug price display mandate, saying non-doctors from the Domestic Trade and Cost of Living Ministry had no business intruding into the exclusive world of medicine.
Let us regulate ourselves, they said.
Is this how the medical profession self-regulates – by breaking a law fundamental to the practice of medicine when compliance becomes inconvenient?
If a waiver is the solution to administrative delays, what is to stop MMC from doing the same thing come January 2027? If the APC is treated like a piece of paper without any legal bearing, then why not just repeal medical licensing requirements from the Medical Act and all other related legislations like the Poisons Act 1952 and the Private Healthcare Facilities and Services Act 1998?
Already, the health minister is talking about changing the Annual Practising Certificate to a multi-year practising certificate. But if MMC doesn’t see the urgency in changing its administrative practices, the same problems will crop up.
Lawyers need to renew their Sijil Annual and Practising Certificate (SAPC) every year. But the Bar Council has never told advocates and solicitors to violate the Legal Profession Act 1976 or exempted the legal profession from the law.
Actions have consequences.
By arbitrarily exempting the medical profession from the law, the MMC is seeking to avoid accountability because patients will be outraged at delays of their cases across public and private health care facilities, while private GPs and consultants may file lawsuits to recover loss of income.
A medical group has demanded that Bank Negara be dragged into this mess and for everyone else to “close the gaps”, similar to another doctors’ association that urged regulators to issue “clear interim guidance” to pharmaceutical suppliers.
An O&G consultant had the audacity to accuse the Pharmaceutical Association of Malaysia (PhAMA) of anti-competition and “cartel” practices, simply because multinational drug makers refuse to sell their products to unlicensed people.
But after first telling CodeBlue that PhAMA member companies won’t supply medicines to doctors without a valid APC, the trade group later told The Star that practitioners who send “evidence” of timely APC application can place drug orders, following intervention from the MOH.
Patients cannot distinguish between a fake doctor and a bona fide one who is simply “awaiting” their APC. One’s certificate, as displayed on the MeRITS public register, is the proof to the general public (and all other third parties) that a practitioner has “complied with requirements”, not a press statement or calls to a random person in MMC’s office on whether “updating information or resolving queries” means that the doctor is legit.
As a health news site, we know that our editorial is an unpopular opinion, but sometimes, we need to draw the line. This is one of those times.
Over the past seven years, CodeBlue has highlighted numerous issues and causes pertaining to doctors in government service and private practice, and we have encountered many good physicians along the way.
Doctors are supposed to be the crème de la crème of society.
Instead, some doctors seem to expect the entire world to accommodate their demands, even to the extent of breaching multiple laws at their behest.
Fundamentally, this national crisis shows how the Malaysian medical fraternity places itself above the law (or perceives itself to be the law, in Judge Dredd fashion) because they believe that they know best – “we know ourselves, we know our doctors, we know what we’re doing” – and as such, everyone else should take their word for it because the profession’s collective esoteric knowledge supersedes an inconsequential document.
Yes, doctors do not want their patients to suffer as a result of MMC’s incompetence, but allowing anyone to call themselves a Doctor and to procure medicines, issue prescriptions, and conduct surgery – without a valid APC – puts the general public at risk.
Who is left holding the bag? Ordinary citizens trust in regulators to protect them, especially if they’re health illiterate, but the State ends up compelling other parties in the health care sector to bend over backwards just so that the fraternity can protect itself.
Do medical practitioners then lecture patients that they should have known better than to trust some quack doctor on TikTok?
Brilliant doctors may think that they don’t need a piece of paper to show how many lives they’ve saved throughout their illustrious career. But the system is meant to protect everyone else. Public interest must supersede personal benefit.
It’s disappointing that the medical profession cannot see that beyond its narrow worldview.
Editorials represent the views of CodeBlue as an institution, as determined through debate in the newsroom. CodeBlue’s Editorial Board comprises editor-in-chief Boo Su-Lyn, senior health writer Alifah Zainuddin, and sub-editor Chua Chern Toong.
