Once again, government doctors are in the spotlight. For how long? A week or two until the next viral issue takes over.
But the damage to our health care system and the slow erosion of the care we give patients continues slowly but surely.
“Doctors are not reporting for duty.”
“Don’t jump to conclusions. Wait a few more days and we’ll see.”
Wait for what? A total collapse?
May this be a wake up call to those in top administration. Doctors in this current generation have options, like leaving the country, setting up their own practice, or quitting medicine completely and venturing into something else.
The list goes on and on! These options were not so readily available (or not there at all) – “DURING YOUR TIME”.
If we are going to use the same approach in trying to retain them, it will fail (has already been failing). The government cannot “take action” against doctors who choose to reject their permanent position offers and continue as contract doctors.
If doctors are rejecting permanent positions that were once used as a carrot to entice them, it’s obvious that the system has failed.
Let’s walk through the frustrations that brought us here, following a government doctor from day one.
The Junior Doctor
The Contract System: Where It Began: 2026 marks a decade of the contract system for doctors. It remains one of the main drivers of today’s brain drain.
The Malaysian Medical Association and others warned about this years ago. Some warnings were heeded; many were ignored.
Slower Progression, Lower Pay: Under the contract system, a house officer on UD9 (previously UD41) becomes a medical officer after two years but stays on UD9 for a third year, with no added benefits or incentives. Under the old system, finishing housemanship meant promotion to medical officer, with pay that matched the heavier responsibility.
Only after that third year are you upgraded to UD10 (previously UD44), still on contract. Your years of service don’t count towards promotion because you’re still a “contract worker”.
You may then wait a year, two, or longer for a permanent UD10 post. Only then do you start another three years before promotion to UD12 (previously UD48). Under the old system, you reached UD48 after five years: two as UD41, three as UD44.
The result is a slower career path and less pay for the same years of service. And we wonder why doctors leave?
The Pre-Specialist
You’ve survived the first phase and decide to specialise. The next hurdle is that the parallel pathway is now tied to the HLP (Hadiah Latihan Persekutuan). The parallel pathway used to let doctors train and sit exams at their own pace and their own cost.
Now it comes with a fixed timeframe and a service bond. The message is clear: even if you’re willing to pay for your own specialist training, you can’t. Follow the programme.
A Post That Can’t Be Refilled: Once you enter training, you leave your hospital for a training centre. On paper, though, your post (jawatan) stays with you. Your old hospital can’t fill it and the department is left short.
The Specialist
Congratulations, you’re a specialist. The pre-gazettement specialist allowance means you get an incentive from day one, as under the old system. But because of the delays above, your grade may be lower, and that allowance a few hundred ringgit less.
Then you’re posted to Sabah, Sarawak, or Labuan, and you pack your bags eagerly. There is no pre-gazettement Sabah/Sarawak specialist allowance, and your Bayaran Imbuhan Wilayah has been cut by 60 per cent compared to your counterparts. Expect to take home nearly RM2,000 a month less than you should.
The Subspecialist
You go to Borneo anyway, and find a place and people you love serving. Next comes subspecialty training, another hurdle. Specialists from the Master’s pathway have no LNPT (Laporan Nilaian Prestasi Tahunan) for their training years. Parallel pathway colleagues do, so they get into subspecialty training earlier.
Three years of LNPT are required, so your training is delayed. A proposed new system would delay everyone further: complete gazettement, collect your LNPTs, and only then apply.
An overseas fellowship may mean taking a loan because the allowance often can’t support a family in some countries. Part of the sacrifice, you tell yourself. But when you come back, you’ll be paid the same as someone who never went because subspecialists get no extra allowance.
In the words of a senior official: “I do not think subspecialists need extra allowances, as I too, am a subspecialist.”
Promotion to Gred Khas C or Jusa C is rare and lacks clear criteria. Many stay stuck at UD15 for years.
Across The System
There are no published manpower norms, meaning no defined minimum staffing to run a service. So staffing at many centres bears little relation to the actual workload.
To those still in government service: the rakyat is grateful. Thank you for pressing on, for persevering, for not giving up on the system.
To PM Anwar Ibrahim, we urgently need the Public Service Department (JPA), the Ministry of Finance (MOF), and the Ministry of Health (MOH) brought to the table, with the Malaysian Medical Association, for real decisions:
- Recognise contract service in full for promotion and seniority, and restoring a clear, time-based career pathway.
- Restore Imbuhan Wilayah parity and introducing a pre-gazettement Sabah/Sarawak specialist allowance, so we stop penalising those who serve in Borneo.
- Recognise subspecialists with a dedicated allowance and clear, published criteria for promotion to Gred Khas C/Jusa C.
- Publish manpower norms and let hospitals refill the posts of doctors away on training.
- In time to come, establish a truly autonomous Health Services Commission that is independent of JPA.
We don’t need more statements. We need real decisions before government health care slides further towards collapse.
The author is the past chairman of MMA Schomos, current Sabah representative in the Malaysian Medical Council, and has served in Sabah for more than a decade. The views expressed here are his own.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
