When the Ministry of Health (MOH) introduced the Supervised Work Experience (SWE) pathway in 2025, it was heralded as a transformative initiative, one intended to benefit both the health care workforce and the MOH itself.
It was presented as a long-overdue reform that would streamline the gazettement process, expedite salary progression, and establish a more structured and equitable framework for specialist recognition and career development.
As members of the pioneer cohort, we were assured that this represented the future of specialist training and credentialling. While some of us recognised inconsistencies and unresolved grey areas during the initial briefings, we chose to place our trust in the system.
In reality, there was little alternative. Nearly a year later, however, that optimism has gradually given way to disappointment.
Perhaps the most striking contradiction lies in the expectations placed upon us. Under the SWE pathway, we are entrusted with the full responsibilities of a specialist. We manage complex specialist-level cases, make independent clinical decisions, and undertake specialist on-call duties.
Yet when it comes to remuneration, we remain entitled only to Medical Officer on-call claim rates. This disparity is difficult to justify.
Under the previous system, although specialist allowances were only granted upon gazettement, specialists were able to retrospectively claim the higher specialist on-call rates for the relevant period.
Under SWE, we receive the specialist allowance earlier, but seemingly at the expense of equitable on-call remuneration. What was presented as an improvement has, in practice, become a trade-off, one that was neither clearly communicated nor reasonably anticipated.
This outcome runs contrary to the very principles upon which SWE was introduced. A programme designed to simplify and improve the transition into specialist practice should not leave its participants financially disadvantaged while expecting them to shoulder identical professional responsibilities.
For many of us, the financial implications are far from theoretical. I was posted to East Malaysia, away from my young family and the commitments we have in our home state.
Like many health care professionals serving far from home, I make every effort to return regularly so that my child does not grow up knowing her parents only through phone calls and video screens. The cost of doing so has become increasingly burdensome, particularly with the steady rise in airfare prices.
Receiving on-call remuneration commensurate with the responsibilities I perform as a practising specialist would not be a privilege; it would simply represent fair recognition of the work entrusted to me.
Instead, I find myself questioning whether the promises made at the inception of SWE have truly been reflected in its implementation.
Equally troubling is the uncertainty surrounding the next stage of our professional development.
Despite the pioneer cohort approaching the completion of its first year under SWE, there remains no clear guidance regarding eligibility for subspecialty training. The criteria, timelines, and application process remain largely undefined.
Consequently, many of us are navigating a pivotal stage of our careers with little certainty about what lies ahead.
Ironically, while the previous system was often criticised for its shortcomings, its pathways were at least familiar and reasonably well understood.
SWE was introduced with the promise of addressing those deficiencies. Yet, unless critical issues surrounding remuneration, recognition, and career progression are clarified promptly, there is a genuine risk that this new pathway will create even greater uncertainty than the one it was intended to replace.
Those of us in the pioneer cohort accepted SWE in good faith. We embraced a new system because we believed the assurances that it would provide a fairer, more transparent, and more efficient route towards specialist practice.
It is therefore entirely reasonable to expect that the commitments made at the outset be honoured in both principle and practice.
Health care professionals have never shied away from serving where they are needed the most. We do so because we recognise the privilege and responsibility of caring for patients.
However, dedication to public service should never be mistaken for a willingness to accept inequity.
If SWE is truly to become the future of specialist training in Malaysia, it must not only demand specialist-level responsibility, but also provide specialist-level recognition, equitable remuneration, and a clearly defined pathway for career progression.
Anything less risks undermining the confidence of those who placed their faith in a system that promised progress but has, thus far, delivered uncertainty instead.
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.
