We can’t afford to lose our specialists

 

MALAYSIA’S shortage of medical specialists has reached a breaking point. Keeping every qualified specialist in the public health system is no longer just an administrative issue. It is a national healthcare emergency.

The numbers make that clear. The Health Ministry had about 9,040 specialists across 29 core specialties at the end of 2025. By 2030, Malaysia will need 22,435. That leaves a shortfall of 13,395 specialists.

At the current training rate of 1,000 to 1,400 specialists a year, we are nowhere near closing the gap.

Against that backdrop, we cannot afford policies that discourage specialists from pursuing further training or remaining in government service.

When following the rules becomes a penalty

(Image: International Citizens Insurance)

Recent reports by CodeBlue highlight a troubling case involving doctors applying for subspecialty training. Some were deemed ineligible because they lacked three consecutive years of performance assessments.

The problem is that during their government-approved Master’s training, they had been told those assessments were not required.

Now, after following official instructions, they face barriers to advancing their careers.

That raises a basic question: should public servants be penalised for complying with the government’s own rules?

The answer should be no.

This is not an argument for lowering professional standards. Subspecialty selection should remain competitive, with decisions based on clinical competence, professional conduct, academic performance and service needs.

But there is a difference between maintaining standards and allowing bureaucratic technicalities to override fairness.

If conventional performance assessments were not required, equivalent evidence such as postgraduate assessments, supervisor reports, examination results, competency evaluations and subsequent performance records should be accepted.

We should never be telling doctors: “You followed our instructions, but now that makes you ineligible.”

Retention is becoming the real challenge

For years, Malaysia has focused on producing more doctors. Today, retaining experienced specialists is becoming the bigger challenge.

Training a specialist requires years of public investment. Beyond qualifications, these doctors accumulate clinical experience, develop advanced skills and eventually train younger colleagues.

When one leaves government service, we lose more than an employee. We lose years of expertise that cannot be replaced overnight.

The consequences are immediate: longer waiting times for patients, heavier workloads for remaining specialists and fewer mentors for junior doctors.

Every policy affecting doctors should therefore be tested against a simple question: will it help Malaysia attract, develop and retain competent medical professionals? If not, it deserves review.

MOH and JPA must work together

This dispute also exposes a wider governance problem. The Health Ministry and the Public Service Department (JPA) cannot continue operating in separate silos when their policies shape the same medical careers.

Doctors should not be left shuttling paperwork between departments while conflicting rules determine their future.

Malaysia needs a single national specialist workforce policy jointly owned by MOH and JPA. It should provide a clear career pathway from medical officer to specialist, subspecialist, senior specialist and leadership positions, so doctors understand expectations before making major career decisions.

Retention also requires competitive working conditions.

Specialists carry enormous responsibility, and their salaries, on-call allowances, workloads, working environments and opportunities for professional development should reflect that reality.

Retention incentives for specialists who commit to serving the public sector, particularly in high-demand disciplines and underserved areas, should be viewed not as additional spending but as an investment in healthcare capacity.

The government has already allocated RM178 million for the MOH Specialist Training Programme in 2026. But producing more specialists without creating reasons for them to stay solves only half the problem.

Measure success by retention

Malaysia should establish a permanent council comprising representatives from MOH, JPA, universities, specialist colleges, professional bodies and practising specialists.

The council should publish annual data on specialist numbers by discipline and state, vacancies, waiting times, retirement and resignation rates, movement to the private sector or overseas, training capacity, workload and shortages in underserved areas.

Most importantly, it should measure retention, not just production.

There is little value in celebrating hundreds of newly trained specialists if an equally large number leave the public system.

Ultimately, rules exist to serve public objectives, not become obstacles to them.

The government should audit all MOH and JPA rules governing specialist training and career progression, and amend those that create unintended barriers for doctors who followed government-approved pathways.

Malaysia’s healthcare future depends not only on producing more specialists but on keeping experienced ones where they are needed most.

The question is no longer whether we can afford to retain our specialists.

It is whether we can afford not to.

KT Maran is a Focus Malaysia viewer.

The views expressed are solely of the author and do not necessarily reflect those of  MMKtT.

- Focus Malaysia.