KUALA LUMPUR, March 10 — Malaysia should strengthen its permanent medical officer workforce instead of recruiting foreign house officers (HOs) to fill vacant training posts in government hospitals, health experts say.
Brig Gen Prof Dr Mohd Arshil Moideen (Rtd), head of school at the Jeffrey Cheah School of Medicine and Health Sciences at Monash University Malaysia, said the perceived manpower gap stems from an over-reliance on trainees to provide frontline service.
“Technically and legally, a house officer is a trainee. They should not be the primary pillar upon which patient management rests,” Dr Mohd Arshil told CodeBlue in an email response.
“The real issue isn’t a shortage of HOs; it’s the lack of permanent medical officer (MO) posts. We must move to a model where the MO is the first line of care, assisted by the HO, rather than the other way around.”
The Ministry of Health (MOH) recently disclosed that only about 6,500 house officers are currently in post out of 12,198 available housemanship training slots nationwide – or 53 per cent – across 48 training hospitals.
The figures have sparked debate over recruiting foreign house officers to address manpower shortages in public hospitals.
The Galen Centre for Health and Social Policy recently proposed recruiting foreign house officers and medical officers from countries like Indonesia as a short-term measure to stabilise the workforce, warning that shortages of doctors and other health workers could worsen over the next decade.
Dr Mohd Arshil, a former joint commander of the Greater Klang Valley Task Force (GKVTF) during the Covid-19 pandemic, said expanding permanent medical officer positions would be a more effective long-term solution.
“To stop the brain drain to Singapore, Australia, and the United Kingdom, the government must abolish the contract system and provide security through permanent positions,” he said.
Dr Mohd Arshil said recruiting foreign house officers could provide temporary relief to overstretched departments and prevent training slots in regional hospitals from going unused.
However, he warned that bringing in more junior doctors without increasing supervision capacity could compromise training standards.
“Without a corresponding increase in senior MOs and specialists to supervise them, more HOs, local or foreign, will only dilute the quality of training and patient safety,” Dr Mohd Arshil said.
Dr Mohd Arshil is a retired public health specialist and epidemiologist from the Malaysian Armed Forces Health Services.
Degree Pathways For Allied Health
Malaysia should also reform its allied health workforce and education system, Dr Mohd Arshil said.
“The barrier is not a lack of interest, but the moratorium on intake quotas. We should lift the quota as long as the academic staff-to-student ratio and training quality are maintained,” he said.
Dr Mohd Arshil further called for allied health programmes such as nursing and physiotherapy to transition from diploma-level training to degree-level qualifications.
“Other nations offer three-year degrees for these roles; by sticking to diplomas, we make our staff less competitive and underpaid, fuelling the exodus of talent.”
He added that sustainable health financing will be essential to support these reforms. “A total reform of the health care system is impossible without reform of how we fund it.”
Dr Mohd Arshil also noted that the proposed National Health Fund (NHF) could help create permanent posts, improve salary structures, and support long-term workforce stability.
“This fund will provide the necessary capital to create new permanent posts, upgrade salary structures, and ensure the long-term sustainability of the national health care system for all Malaysians.”
Focus On Retaining Local Doctors
The Malaysian Medical Association (MMA) also opposes recruiting foreign house officers as an immediate solution.
MMA president Dr R. Arasu said Malaysia’s current shortage of house officers does not justify importing foreign trainees in the near term.
“Yes, we are experiencing shortages, but not at a crisis level that justifies importing house officers within months. That would be an expensive stop-gap, not a sustainable strategy,” Dr Arasu told CodeBlue in a written statement.
“If the system is unattractive to Malaysians, bringing in foreign HOs does not fix the problem; it merely masks deeper structural weaknesses.
“The priority must be to retain and motivate our own graduates through competitive remuneration, permanent career pathways, better working conditions, and fair manpower distribution,” he added.
Dr Arasu also warned that recruiting foreign house officers while local doctors face contract uncertainty could undermine morale.
“Importing junior doctors while local graduates struggle with contract uncertainty risks damaging morale and sending the wrong signal. Bottom line: If it is attractive, we do not need to import. If it is unattractive, importing will not fix it.”
Dr Arasu said increasing STEM (science, technology, engineering, and mathematics) participation and enrolment in health-related courses will depend on improving the attractiveness of health care careers.
“Students choose careers based on stability, fair pay, work-life balance, professional respect, and clear progression, not slogans. The most effective way to increase STEM and medical enrolment is to make health care a profession young Malaysians aspire to, not endure.
“When health care careers are stable, respected, and fairly compensated, interest will grow organically,” he said.
