Public Service director-general Wan Ahmad Dahlan Abdul Aziz recently suggested that the country’s doctor shortage and brain drain could be mitigated if doctors had a stronger “sense of nationalism.”
At face value, this sounds appealing. But it reflects a troubling oversimplification of a deeply structural problem. As doctors and as public servants, we are not indifferent to the idea of serving the nation.
However, patriotism should not be conflated with unconditional sacrifice. Choosing to leave government service, or even to work abroad, does not make one less patriotic. To frame it that way risks turning a workforce crisis into a moral judgement.
This is not policy. This is moral coercion.
Malaysia’s doctor shortage is real, and it is serious. It has the potential to escalate into a national health care crisis. Yet it cannot be resolved by appealing to sentiment alone. The question is not whether doctors love their country enough; the question is whether the system allows them to stay.
Let’s be candid about the realities. Doctors in the public health care system face long hours, heavy workloads, limited job security (particularly for contract officers), and historically constrained access to specialist training.
While recent policy changes, such as improved pathways to permanent positions and the introduction of relocation allowances are steps forward, they do not fully address the core concerns of sustainability, career progression, and financial security.
A profession built on sacrifice cannot survive on sacrifice alone.
To become a doctor in Malaysia requires years of exceptional academic performance, followed by intense undergraduate training. This is only the beginning.
Housemanship, medical officer years, and specialist training demand further endurance, discipline, and repeated high-stakes examinations. It is a long and difficult journey. Imagine if anyone can sustain this if not largely by passion, but passion has limits when the system does not reciprocate.
If a doctor chooses to leave, whether for better training opportunities, improved working conditions, or financial stability, this should not be interpreted as a failure of patriotism. It is more often a reflection of policy gaps.
We must also confront an uncomfortable question: Why is the burden of national economic constraints being placed disproportionately on doctors?
When the economy tightens, the expectation that often emerges is that health care workers should “understand,” “stand with the government,” and accept less. Yet no other highly skilled profession is asked as routinely to absorb systemic inefficiencies in the name of service.
Doctors are not asking for privilege. They are asking for fairness, sustainability, and respect for the value of their work.
If current trends persist, we may eventually see fewer applicants entering medical school. The pipeline will shrink. Institutions may continue to operate but increasingly, they may produce graduates who intend to serve elsewhere, like overseas.
Worse still, how ironic it will be when Malaysians flood Facebook and Instagram with praise, thumbs up, applause, and “proud to be Malaysian” after receiving treatment from a Malaysian specialist abroad.
Suddenly, nationalism feels stronger at 30,000 feet and beyond our borders. Like how we celebrated the Malaysian liver transplant expert in China, we admire the success, we amplify the story. Even political figures are quick to highlight such achievements, pointing proudly to Malaysians excelling overseas.
Yet, when these same doctors choose to leave in search of better systems, clearer career pathways, and fairer treatment, their decisions are questioned. Their patriotism is scrutinised.
So which is it?
Are they national assets when they succeed abroad, but a national disappointment when they choose to go? Perhaps patriotism, in this context, is not about where you serve but where your success is most convenient to celebrate.
The author is a clinician serving in the Ministry of Health (MOH). CodeBlue is providing 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.
