Senator Dr RA Lingeshwaran was reported to have said recently that a total of 3,046 contract doctors had resigned in the last three years alone – 768 in 2021, 1,354 in 2022, and 924 in 2023 – adding that it was based on health ministry data.
The former Sungai Bakap Hospital director described the numbers as “troubling” and called for an in-depth study into the reasons for doctors quitting the civil service.
Speaking to FMT, doctors speaking on condition of anonymity explained that low wages, the lack of permanent positions and a poor work-life balance were among the reasons for the exodus of contract doctors.
One former contract doctor said she left the civil service in January this year, citing chronic fatigue due to an increased workload caused by an acute lack of manpower.
She said a shortage of housemen left serving medical officers with additional responsibilities, exacerbating burnout among them.
“How are we supposed to focus on providing proper care for patients when we are tired ourselves? This could lead to medical errors,” she told FMT.
She said the low on-call allowance and stagnant salaries also pushed her to quit the civil service.
“Our on-call rate is very low. If I were to do locum elsewhere, I would get paid RM40 (per hour), but when I work extra hours on-call, I only receive RM9 to RM10,” she said.
“The increments have been stagnant for quite some time. In fact, I earn less as a medical officer compared with when I was a houseman. The ongoing inflation isn’t helping.”
Meanwhile, another government doctor pointed to the “tedious process” of placement confirmations and contract renewals as a significant factor that had prompted many to leave the civil service.
She said she was made to wait five years for a permanent placement.
“If you’re just going to be a contract doctor, you have to keep waiting for years without getting a placement or a promotion,” she added.
“The worst thing is for the first three years it’s one contract, then two years for another contract, and thereafter, you have to renew your contract every year. So every year, you have to do (up) documentation (detailing hours and service) just to renew your contract,” she said.
She said the government’s basic pay of RM4,000 per month for fresh graduates pales in comparison with the private sector, which offers remuneration of between RM8,000 and RM12,000.
She also said private practice offers a healthier work culture, which reduces the potential for burnout.
Meanwhile, Dr Timothy Cheng, vice-chairman of the Malaysian Medical Association’s (MMA) section for house officers, medical officers, and specialists (Schomos), said many doctors left the civil service to pursue postgraduate studies on government scholarships.
He said doctors previously had the option of pursuing postgraduate studies and specialist training independently at their own expense, or with government sponsorship.
However, he said, all public sector doctors seeking specialisation are now required to apply for a government scholarship under the Hadiah Latihan Persekutuan (HLP) programme regardless of whether they choose to specialise by way of a local master’s degree or via the parallel pathway scheme.
The HLP requires all trainees to serve longer training periods and a seven-year bond.
“Now, when you apply for the government scholarship, it comes with a bond. No one can be a specialist at their own pace or with their own money,” Cheng told FMT.
“You have to register with the government and then you are bonded to them. Many don’t want that, so they leave.”
He added that subpar equipment and inadequate facilities, largely prevalent in district hospitals, also contribute to the frustration experienced by medical staff.