The Malaysian Medical Association (MMA) is deeply concerned by the worsening doctor shortage at Hospital Ranau and the Sabah State Health Department’s confirmation that 67 per cent of replacement medical officers from outside Sabah failed to report for duty following the recent permanent appointment exercise.
The consequences are alarming. Hospital Ranau lost 11 of its 19 medical officers, yet only one of seven identified replacements reported for duty. The hospital is now operating with just nine medical officers, including its director.
Reports of doctors working 48 to 72 consecutive hours with inadequate rest are deeply disturbing. Such working conditions are unsustainable and pose serious risks to patient safety and doctors’ well-being.
How was a hospital allowed to lose more than half its medical officers without sufficient replacements in place? What contingency measures were established to ensure continuity of care? The Ministry of Health (MOH) must provide answers.
An appointment letter does not staff an emergency department, cover a ward or relieve an exhausted doctor. Workforce planning must be measured by the number of doctors actually reporting for duty, not the number of appointments offered.
MMA welcomes the announcement of 750 permanent medical officer positions for Sabah and Sarawak. However, with 67 per cent of replacement candidates from outside Sabah failing to report for duty in the recent exercise, what will be different this time?
Permanent appointments are important, but permanent status alone will not resolve the problem if the barriers to recruitment and retention remain unaddressed.
Furthermore, with successful applicants under the new recruitment exercise only expected to report for duty in February 2027, MOH must ensure that existing staffing shortages are addressed without delay.
MMA calls on MOH to take immediate action to:
Restore safe staffing levels: Deploy sufficient doctors to Ranau and other critically understaffed hospitals, including temporary support from Peninsular Malaysia where necessary. The deployment of three temporary relief medical officers is welcome, but MOH must ensure adequate and sustained staffing support, given the severity of the shortage. Safe working hours, adequate rest, and continuity of patient care must be prioritised.
Prevent further staffing disruptions: Future transfer and appointment exercises must be coordinated with confirmed replacement arrivals, supported by service-impact assessments and contingency staffing plans to ensure essential health care services are not compromised.
Introduce a comprehensive recruitment and retention package: This must include competitive remuneration, improved Regional Incentive Payment (Bayaran Insentif Wilayah, BIW) and appropriate hardship allowances, upfront relocation assistance, suitable accommodation, predictable posting and transfer arrangements, and clear opportunities for specialist training and career advancement. Service in underserved areas should receive meaningful recognition.
Ensure transparency and accountability: Publish actual staffing numbers, vacancies, replacement reporting rates and progress in restoring services, particularly in facilities facing critical shortages. Minimum safe staffing requirements must be established, with immediate intervention when these cannot be met.
Before applications for the 750 permanent positions open on November 9, MOH should clearly announce the full employment and incentive package. Doctors need to know where they will serve, what support they will receive and what career opportunities await them.
MMA recognises that doctors have legitimate family, financial and career considerations. Addressing these concerns is essential if the government is serious about attracting and retaining doctors in Sabah and Sarawak.
The situation in Ranau is not an isolated problem. According to the Sabah State Health Department, Sabah is facing a shortfall of approximately 245 medical officers following the recent permanent appointment exercise, reflecting wider weaknesses in workforce planning and retention.
We cannot keep repeating the same recruitment approach, leaving the same problems unresolved and expecting different results.
The doctors who remain must not be made to bear the consequences of inadequate workforce planning. Patients deserve safe, timely care, while doctors deserve reasonable working conditions and the support needed to provide it.
MOH must act now. Success is not measured by how many permanent positions are announced, but by how many doctors report for duty, remain in service and are available to care for patients.
This press statement was issued by MMA president Dr Sivanaesan Letchumanan.
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