Seventy per cent of Malaysians depend on the public health care system for their care. When we lose a subspecialist, it is the public patient who pays the price through longer waiting times, delayed treatment and reduced access to specialised care.
Malaysia is not facing an excess of specialists. It is facing a critical shortage. The government itself has acknowledged that Malaysia is short of nearly 11,000 specialists.
At a time when the country is working to close this gap, we should be removing barriers to specialist training, not creating new ones.
Malaysia needs more subspecialists in areas such as cardiology, oncology, gastroenterology and neonatology. Yet specialists seeking subspecialty training are facing increasing uncertainty over eligibility requirements.
The subspecialty programme is operated by the Ministry of Health (MOH), but the eligibility rules and LNPT (Annual Performance Appraisal Report) requirements fall under JPA.
This means the ministry responsible for developing the health care workforce does not fully control the rules governing progression into subspecialty training.
MMA has raised these concerns with the MOH’s senior leadership recently. We are speaking publicly now because specialists — and the patients who depend on them — cannot afford another cycle of uncertainty.
MMA is particularly concerned about the LNPT requirement for the 2026/2027 intake, which shifted from the best three appraisals out of five years to three consecutive years. Such changes should be clearly communicated and implemented with adequate notice.
One of the key issues involves specialists undergoing recognised Masters training. These doctors continue serving patients while training, yet their training years are often recorded as cuti belajar, resulting in gaps in LNPT records.
This makes little sense. A doctor should not be penalised for undertaking government-recognised training while continuing to serve in the public health care system. The same government that sponsors and recognises the training should also recognise the service provided during that period.
This is not simply a workforce issue. It is a patient care issue.
Under the current system, a doctor may require more than 15 years to progress from House Officer to subspecialist. Every additional delay shortens the number of productive years they can serve the nation as a subspecialist.
Every delayed subspecialist means one less future cardiologist, oncologist, gastroenterologist or neonatologist available to serve patients.
Doctors accept competition and high standards. What they cannot accept are shifting goalposts, uncertainty and decisions without explanation. Delays and inconsistencies discourage specialists from pursuing further training and risk pushing talent elsewhere at a time when Malaysia needs more specialists.
MMA is also concerned that unsuccessful applicants are often informed only that they were “Tidak Berjaya” without any explanation. Decisions that affect careers and ultimately the country’s future specialist workforce should be transparent. Written reasons and a proper appeal mechanism should be available.
The solution is straightforward and does not require another task force. MMA calls for:
- Clear written clarification of LNPT requirements and eligibility criteria.
- Any new interpretation to be applied prospectively, not retrospectively.
- Appropriate recognition of service performed during recognised training years.
- Standardised eligibility requirements across recognised pathways.
- Written reasons and a proper appeal mechanism for unsuccessful applicants.
- Greater emphasis on competency-based selection.
- Stability and predictability in selection criteria.
- Continued recognition of Sabah and Sarawak in workforce planning considerations.
MOH, the Public Service Department (JPA), and the Ministry of Higher Education (MOHE) must work together to ensure that workforce policies support, rather than hinder, the development of future subspecialists.
Malaysia needs more subspecialists, not fewer. A specialist blocked at home is a specialist recruited abroad. And the patient left behind is in a public hospital.
This press release was issued by Malaysian Medical Association (MMA) president Dr R. Arasu.
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