Hence the recent action by the health ministry (MOH) to employ some on contract posts is unfair to our young doctors.
There are three concerns over the recent announcement by the health minister regarding the employment of our young doctors on a permanent or contract scheme.
Firstly, the contract medical officers are being paid less than their counterparts who have been accepted as permanent staff.
Medical officers employed on a permanent scheme are paid based on a UD44 grade, while those on a contract scheme are paid based on a UD41 grade.
Both officers will be doing the same work; hence it is unethical to give them different wages.
MOH has suggested that the pay differential between these two groups is small but it can only widen with time as increments and promotions will be totally different.
Secondly, contract medical officers are not being allowed to access local postgraduate training programmes.
These programmes should be an open system for all Malaysians.
Denying entry to postgraduate training for the contract medical officers will result in some of them leaving for other countries, especially those who use the “alternative” training pathways (overseas examinations) for specialist training.
Others will not attempt specialist training. Note that some disciplines (especially the surgical ones) do not have easy “alternative” pathways for specialist training.
Hence, we will retard the number of specialists we train for our country.
We will also probably create a two-tier system in MOH facilities, with permanent officers offered more training in the departments they work in and contract officers being used as “workhorses” to do grunge work.
Thirdly, it does not appear clear as to how doctors are selected for permanent or contract posts.
The MOH must make public its criteria for selection.
In addition, we encourage the MOH to publish a comparative social demographics of those who have been selected for the permanent and contract posts.
We would like to see whether this selection has been based on ethnicity, religion, scholarship holders, children of VIPs (or those with connections), local vs foreign universities, or whether it has been based on merit.
It should be based on the performance of the house officer during the two years’ of training or possibly an exit exam to select the best.
Who is responsible for this failure?
This problem of limited MOH posts for house officers and medical officers has been foreseen and discussed for more than 15 years.
Many individuals have expressed their concerns over the years to the MOH.
We could have acted more than a decade ago to prevent this farce and put in place measures to control the number of doctors being trained. But we have failed to do so.
Will the MOH now take responsibility for this failure?
The suggestions for dealing with the current crisis are not merely to increase the number of new posts for medical officers. It must be two-fold.
Firstly, there must be a drastic reduction in recognised universities overseas, especially locations where our students are poorly trained (Russia, Indonesia, Egypt, etc).
This will limit the centres where our students can train.
Secondly, shrink the local medical schools by 50%. Some of our local medical schools need to improve in the number and quality of trainers and the availability of training sites (hospitals).
The shrinking (or amalgamating) of local medical schools will improve both the quality as well as reduce the manpower glut.
Even if these changes are done within the next one year, it will take another five years (the medical degree takes at least five years to complete) for the changes to affect the outcome of the number of new doctors graduating.
We feel for these young doctors and their families. We would feel cheated if we were in their position.
They want to serve and should be given a fair deal for their service, but many of them have now been left in the lurch.
Real action needs to be taken today and not another decade from now.
Dr Amar-Singh HSS is a senior consultant paediatrician.
The views expressed are those of the author and do not necessarily reflect those of FMT.