The Malaysian Medical Association (MMA) calls on the government to urgently revert to the previous percentage-based Regional Incentive Payment (BIW) and introduce stronger incentives to attract and retain doctors in Sabah and Sarawak.
MMA is deeply concerned by reports that large numbers of medical officers did not report for their permanent postings in Sabah and Sarawak on September 28, 2026.
Some facilities reportedly received no new medical officers, while others recorded no-show rates of between 70 and 76 per cent. The official figures should be urgently verified and made public.
If contract medical officers are refusing permanent positions, it points to deeper problems that cannot be ignored.
For years, doctors have sought the security of permanent appointments. The fact that some are now reportedly declining these positions should be a clear warning that the current situation and conditions in East Malaysia are discouraging doctors from serving there.
This is not simply about permanent versus contract employment. Doctors may be required to relocate far from their families, bear substantial moving costs, and serve in severely understaffed facilities with demanding workloads and, in some areas, inadequate accommodation and support.
Health care workforce shortages and retention were also among the issues MMA recently discussed with Sarawak Deputy Premier Dr Sim Kui Hian, reflecting the urgent need to address the manpower challenges facing health care services in the state.
We must stop blaming doctors and start asking why the system is failing to attract and retain them.
MMA calls for urgent action to:
- Revert to the previous percentage-based BIW. The current fixed payment has significantly weakened the value of this important incentive for serving in Sabah and Sarawak.
- Introduce a dedicated East Malaysia service allowance for medical officers, alongside supplementary incentives such as housing assistance, transport support and retention bonuses.
- Review relocation assistance. It must reflect the real cost of moving to Sabah and Sarawak and should be provided before doctors relocate, rather than months later through a claims process.
- Provide certainty on the duration of East Malaysia postings. Doctors whose long-term preference is to serve in Peninsular Malaysia but who are posted to Sabah or Sarawak should be given a clearly defined period of service, with a transparent pathway for transfer back upon completion. Knowing from the outset how long they are expected to serve may encourage more doctors to accept these postings.
- Improve living and working conditions. Rural quarters must be safe, properly maintained and adequately furnished, with reliable water, electricity, internet access and transport connectivity.
- Reward service in underserved areas with meaningful career progression. Rural service should count towards postgraduate training, specialist pathways, promotions and preferred future placements.
- Create better awareness and voluntary pathways for East Malaysia service. Doctors should receive clear information about the challenges, opportunities and career benefits before selecting their placements.
Compulsory postings and administrative directives alone will not solve this problem. Doctors need compelling reasons to go — and compelling reasons to stay.
With Budget 2027 approaching, MMA hopes these issues will be sufficiently addressed. The Budget must provide the resources needed to strengthen incentives, improve working and living conditions, support relocation and, most importantly, retain health care workers in areas where they are urgently needed.
MMA has repeatedly called for Malaysia’s public health care allocation to be progressively increased towards 5 per cent of GDP. Adequate investment is essential if we are serious about addressing chronic manpower shortages and strengthening health care delivery in Sabah and Sarawak.
Sabahans and Sarawakians deserve the same timely and safe access to health care as every other Malaysian.
An empty post does not treat a patient. A permanent appointment without a credible retention strategy is merely a number on paper.
The government must act urgently. Every further delay adds to the burden on doctors already serving in Sabah and Sarawak and places patient care under greater strain.
This press statement was issued by MMA president Dr Sivanaesan Letchumanan.
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