Why are Malaysian doctors quitting, striking and preferring to work in Singapore?
Malaysian doctors leaving the country for greener pastures isn't a new problem.
Wed, 17 May 2023 at 6:51 am GMT+1
A government medical contract doctor holds placard during a walkout strike at Kuala Lumpur Hospital in Kuala Lumpur, Malaysia, on July 2021. (Photo by Wong Fok Loy/SOPA Images/LightRocket via Getty Images)
by Ushar Daniele
After nine years as a government medical officer in Malaysia, in 2017, Dr Khoo Yoong Khean decided to take the leap to secure a job abroad; specifically, in Singapore.
One of the reasons for his then-planned move across the Causeway, Khoo says, was the inability to find viable opportunities to further his career as a practising doctor in Malaysia. This, despite having served the Health Ministry for almost a decade.
It was good fortune, then, that his interest in management and public health, among others, put Khoo in good stead with Singaporean employers.
"Back then, Singapore was willing to let me explore other areas of healthcare. So, I grabbed that opportunity," he said.
Brain drain not new
Malaysian doctors leaving the country for greener pastures isn't a new phenomenon.Prof Datuk Dr Adeeba Kamarulzaman, a former dean of Universiti Malaya's (UM) medical faculty, for one, recently said that Malaysia has been losing its "best and brightest" medical minds for years.
According to her, at least 30 UM grads annually choose to do their house officer training in Singapore instead of Malaysia.
Medical graduates in Malaysia are required by law to undergo an internship, or "housemanship" period, of two years in a government hospital before they are allowed to register for a practising licence in the country.
After that, there are a further two years of compulsory service in hospitals and clinics under the Health Ministry.
The problem, unfortunately, is that there is no guarantee of a full-time job once the minimum four years of service are up.
Some doctors, however, are offered contract positions.
Yet, this is where things get worse.
Unequal rights
Essentially, Malaysia has had to deal with a glut of doctors as a result of the rapid sprouting of private medical colleges and a large number of medical grads returning from overseas.This is why the government introduced a contract system for doctors in 2016.
The trouble with this is the lack of clear policies for the absorption of contract doctors into full-time government service.
To make matters worse, contract doctors claim to have been unfairly done by, both in terms of wages and benefits. This, despite these doctors regularly undertaking the same amount of responsibilities as their full-time counterparts.
The situation, abetted by contract doctors being put under severe strain since early 2020 on account of the COVID-19 pandemic, eventually resulted in a nationwide demonstration in July 2021 that saw mass walkouts and demands for cessation of the current policy and more full-time positions to be offered.
Very little changed, however. And in April this year, another group of doctors was reported to have been marshalling another strike.
Of damp squibs and persistent issues
To be clear, the record shows that the warned-about protest, allegedly involving 10,000 to 12,000 doctors that was supposed to have brought Malaysia's public healthcare system to its knees, never transpired. There were also no mass resignations as the organisers had predicted.Additionally, the government has since pledged to begin absorbing junior contract doctors into permanent positions, promising that as many as 12,800 contract doctors would be brought into the service full-time in three years.
Even so, the issues of low wages and a lack of rights, privileges and benefits have yet to be adequately dealt with.
This is why the appeal of moving abroad for work remains, says an anonymous spokesperson for Hartal Doktor Kontrak (HDK), the group that organised the 2021 strike.
Junior contract doctors, he notes, have also been the victims of bullying and harassment. And worse, Malaysia's healthcare service remains chronically understaffed, and the government appears reluctant to deal with this and/or provide conducive working environments for healthcare professionals.
"Many junior doctors continue to leave for greener pastures, and Singapore is one of the destinations," he said.
Khoo, meanwhile, opines that more Malaysian doctors than ever are likely looking to exit the country, and that has probably been due to the events of the past few years under COVID-19.
"The pandemic probably exacerbated the situation, with many health workers feeling burnt out from work. Ultimately, it's a mix of factors; of remuneration, workload, mental well-being and career progression," he said, adding that, unfortunately, there remains no easy fix.
That being said, Khoo feels the government needs to consider short-term solutions like increasing wages, and in the longer term, being transparent about permanent career opportunities and career progression.
"There needs to be a top-down effort to improve working conditions; be tough on cases of bullying, and sexual harassment and encourage better working relationships," he said.
Both Khoo and the HDK spokesperson add, too, that a well-funded, efficient healthcare system will be able to manage patient loads better and thereby, make contract doctors' jobs easier and open up new career pathways.
This, they say, in the long run, may cause Malaysian doctors to refrain from considering trading their jobs in the country for new lives abroad; in Singapore, Ireland, the United Kingdom, Australia and even the United States.
