The health minister’s statement on Nov 1 that medical officers may be on contract during their entire two-year mandatory service with the government if they fail to get a permanent appointment is something not unexpected but may still send many doctors-to-be and junior doctors into a shock wave over their uncertain future.
Faced with the reality and the fact that the ministry cannot indefinitely absorb the continual influx of 5,000 or more newly minted doctors every year, there will be many doctors facing the prospect of no jobs after their compulsory service with the government.
It has been estimated that perhaps up to half of the annual turnover of doctors may not have their contracts renewed or offered permanent posts after their two years’ service as medical officers, in which case they will need to look for jobs in the private sector, universities, etc, many of which may not be doctoring posts.
So, how did we come to such a mismatch of doctors’ supply and demand and, more importantly, why is the situation getting worse instead of improving?
The answer is obvious as we are producing too many doctors too fast. Looking at Malaysia with a population of 32 million, we have 34 medical schools at last count, producing about 4,000 doctors annually, combined with more than 1,000 returning from overseas. According to the statistics department, in 2017, the doctor-to-population ratio is 1:554.
Australia, with a population of 25 million, has 13 medical schools, and the United Kingdom, with a 67 million population, has 33. This means Malaysia may have the highest number of medical schools per population ratio in the world.
The answer to the glut is to curtail supply but the political willpower to do the needful is painfully challenging.
Another factor is the quality of training whereby there are not enough training slots, trainers and even patient load for junior doctors to gain adequate skills and experience. Although there is a quality assurance mechanism in place for medical schools and emphasis on acceptable standards, it is rare to hear of any medical school closing down or overseas medical schools being derecognised, which raises the question of whether we are serious in maintaining the standards required.
There have been many other suggestions and proposals to solve the oversupply of doctors. Some are already being implemented such as a moratorium on new medical schools and increasing the quota for foreign intake by our local universities. Other suggestions are being seriously considered.
The government has also set up a medical officers placement committee to expedite their movement within the health ministry after completing their housemanship. Ultimately, despite what is done or implemented, we will still see a sizeable number of doctors who will find themselves jobless and forced to move into other industries totally unrelated, just to earn a decent living.
There was a report that alluded the government is not obliged to ensure every doctor gets a job, its main priority being the provision of quality medical services. Unfortunately, the government is achieving neither.
In reality, it is the government that allowed the mushrooming of medical schools with its massive overproduction of doctors. Now, it is time for the government to, once and for all, do the much needed remedial action and heal our healthcare, so to speak.
What needs to be done is painfully obvious, but there is no other choice lest we want to see total catastrophe to our healthcare system.
Dr John Teo is an FMT reader.
The views expressed are those of the author and do not necessarily reflect those of FMT.