KUALA LUMPUR, July 20 — Less than half of medical officers complete specialty training on schedule at a current 46 per cent graduate on time (GOT) rate, the Public Service Department (JPA) has revealed.
According to JPA, the low GOT rate has direct implications on management of training reserve posts (JSL) because doctors who haven’t completed training remain in their position for longer than expected, therefore reducing opportunities for other medical officers to undertake specialty training.
In a lengthy six-page statement that raised other issues like GOT, permanent positions for the health service, and health workforce distribution, JPA defended its decision to retain its Annual Performance Appraisal Report (LNPT) requirement for subspecialty training this year.
The Ministry of Health (MOH) had provided 400 slots for the 2026/2027 subspecialty training intake, with a total of 342 confirmed recipients, including 35 specialists who were accepted based on a special exemption by JPA that included supervised work experience (SWE) evaluation as an addition to two-year LNPTs.
Although the MOH requested JPA to use LNPT 2025 to complete the requirement for three years of LNPT, JPA decided not to exercise this exemption for the 2026/2027 intake, recommending instead that the MOH bring forward the remaining 58 slots to next year’s intake.
“Every consideration made by JPA is based on administrative protocols in force, with supporting official records and documentation to ensure integrity, effectiveness, and accountability in each decision-making process,” said JPA.
Consultant nephrologist Dr Rafidah Abdullah has been attacking JPA over the past week about the subspecialty training issue that disproportionately affected doctors who underwent local Master’s programmes and were unable to fulfil the requirement for three consecutive LNPT years, due to administrative categorisation of their study leave.
She has filed complaints to the Malaysian Anti-Corruption Commission (MACC) and the Prime Minister’s Office.
Over 66,000 New Positions Without Trade-Offs Created For MOH From 2019
JPA pointed out that it approved the creation of 66,312 new positions without trade-offs for the MOH, with financial implications amounting to RM6.7 billion, from 2019. A trade-off means that a new position can only be created after eliminating an existing one.
These comprised 53,516 new positions approved from 2019 to 2025 to support the operation of new or upgraded health care facilities, with a financial implication of RM4.5 billion, and the creation of 12,796 permanent positions for medical, dental, and pharmacy officers from 2022 to June 30, 2026, with an RM2.2 billion financial implication.
“However, JPA’s consideration is not limited to these three service schemes alone. Every application from MOH also takes into account the needs of 83 other service schemes, which are equally important in ensuring that the entire national health ecosystem continues to function comprehensively and effectively.”
JPA added that the 66,312 new positions for the health service over the past seven plus years, created at a cost of nearly RM7 billion, didn’t take into account new positions in the MOH that were created from organisational restructuring, such as the digital health division, health transformation division, and strengthening of the allied health sciences division.
At the same time, JPA and the Ministry of Finance (MOF) are currently evaluating an application to create 13,000 new positions without trade-offs to support the operation of 256 new or upgraded health care facilities, with an estimated financial implication of RM1.25 billion.
“These facts show that efforts in strengthening the public health care system remain the government’s priority. The creation of new positions, strengthening health workers’ career pathways, and development of health care facilities are continuously implemented to ensure that people continue to receive quality health care services,” said JPA.
Current Challenge: No Longer Merely Creating Positions
JPA said the current challenge facing the public health care system was no longer solely about creating new staffing positions, but about health workforce distribution.
Citing MOH’s Health Facts 2025, JPA noted that Malaysia had a doctor to population ratio of 1:403 across the public and private sectors, excluding house officers and new full registrations.
The total number of doctors in the country as of December 31, 2024, were 74,517, comprising 45,697 in MOH (61 per cent), 21,013 in the private sector (28 per cent), and 7,807 in non-MOH (public sector) [11 per cent].
Malaysia’s 1:403 doctor-to-population ratio, said JPA, reached the country’s 2026 target.
“However, this achievement does not mean that all health facilities have the same human resource capacity. There are significant differences in the distribution of medical officers between states and regions,” said JPA.
The central agency noted that the ratio of medical officers to population in Putrajaya, for example, was approximately 1:19, far exceeding the national average.
“These statistics show that the current challenge is no longer merely related to creating new positions. Instead, the challenge now centres on the recruitment, placement, and optimal utilisation of human resources so that every hospital and health facility has the capacity required to provide the best services to the people,” said JPA.
“In this context, the development of medical officers’ specialist expertise also plays an important role. The specialist training system must be implemented in a well-planned manner to ensure that more medical officers have the opportunity to undergo training, complete their studies within the stipulated period, and return to serve as specialists in health facilities throughout the country.”
Health DG Responsible For Workforce Distribution, Placement, Filling Positions
JPA explained that based on its records, the MOH has been allocated positions in bulk to fill posts according to operational needs since at least 1993. Consideration for the creation of new positions remains subject to the authority of JPA and MOF.
JPA pointed out that the Health director-general – as the head of service for the medical, dental, pharmacy, nursing, assistant medical officer, and allied health professions service schemes – was responsible for determining the recruitment, placement, and filling of positions in hospitals and health facilities based on service delivery needs.
“This approach enables MOH to manage human resources in the health sector more flexibly, efficiently, and responsively to ensure that the needs of hospitals and health facilities nationwide can be met more effectively,” said JPA.
“To ensure that the administration of position management is always at its best, JPA conducts periodic audits as part of its continuous monitoring and improvement mechanism.
“Based on the findings of these audits, JPA identified several areas for improvement, particularly in relation to the recruitment and utilisation of positions so that they are better aligned with the actual needs of health facilities.
“Accordingly, JPA has recommended that the review and reallocation of positions be carried out periodically so that available human resources can be utilised more optimally and service delivery to the people can continue to be strengthened.”
CodeBlue recently reported that MOH’s doctor workforce has contracted for the first time in more than a decade, losing 1,444 doctors two years ago from a total of 53,512 doctors in 2023 to 52,068 in 2024.
The historic contraction occurred as doctor no-shows for permanent posts spiked over the past few years to MOH’s own forecast of 50 per cent no-shows this year, at least for Sabah. The ministry also reported resignations of more than 3,500 medical officers from the public sector between 2023 and 2025.
