The ongoing grievances from medical officers who have completed all required training and assessments on time, yet continue to face unexplained delays and inconsistencies in specialist gazettement, placement, and access to sub-specialty training, raise questions on how the selection criterion is determined, what qualities are factored into the decision-making process.
Recent gazetted specialist lists issued by the Ministry of Health (MOH) reveal that doctors approved across different committee meetings were assigned the same tarikh lapor diri. However, in reality, only those who received their gazettement letters earlier were able to register with the National Specialist Register (NSR), apply for sub-specialty training, receive allowance back-payments, or request transfers closer to their hometowns.
This discrepancy creates an unfair situation where doctors of the same cohort and qualification are treated differently, without any transparent or publicly explained criteria. Administrative timing, rather than merit or service record, ends up determining career progression.
The impact is especially severe for doctors serving in Sabah and Sarawak. Without gazettement letters and NSR registration, they are unable to apply for transfers back to Peninsular Malaysia, prolonging separation from their families despite having fulfilled all training requirements. Many have already spent more than a decade in the public system, often far from home, only to find their career progression stalled indefinitely.
Medical officers waiting in queue have shared that specialist approvals are decided allegedly through fraternity-based meetings involving the Director-General of Health and heads of services. However, the criteria used to prioritise candidates — who is approved first, who must wait, and why — remain unclear to affected doctors. This lack of transparency fuels frustration, erodes morale and undermines confidence in the system.
The problem extends further into sub-specialty training. Entry into sub-specialties depends heavily on the timing of gazettement and NSR registration, meaning delays can permanently disadvantage doctors through no fault of their own. Career pathways become distorted by administrative bottlenecks rather than competence or national health care needs.
While the new Specialist Workforce Expansion (SWE) pathway may improve matters for future cohorts, it does not address the inequities faced by doctors currently trapped in the existing system.
The MOH needs to urgently clarify:
- The criteria used to determine the order of specialist gazettement among doctors from the same cohort.
- How placement decisions are made, particularly for those seeking to return to their hometowns after long years of service.
- The selection and queuing mechanism for sub-specialty training.
To improve the system and prevent further loss of talent, MOH should consider:
- Publishing clear, standardised and measurable criteria for gazettement, placement and sub-specialty selection.
- Ensuring synchronised issuance of gazettement letters and NSR registration for doctors from the same cohort.
- Introducing an appeal and review mechanism for doctors who believe they have been unfairly delayed or overlooked.
- Taking family considerations and years of service into account in placement decisions.
Malaysia cannot afford to lose its medical talents to developed countries simply because of opaque and demoralising administrative practices. Transparency and fairness are essential to retain our doctors and protect the future of public health care.
Dr Mah Hang Soon is MCA deputy president.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
