Congratulations to the five cardiothoracic surgeons who have been registered by the Malaysian Medical Council (MMC). Health minister Datuk Dzulkefly Ahmad said the registration of the five specialists marked the resolution of a long-standing issue on the implementation of the parallel pathway programme and the recognition of international qualifications, particularly in the field of cardiothoracic surgery.
When there was an urgent need in the country for these specialists, the cabinet, parliament and other agencies moved forward speedily in changing the laws to legitimise their studies and training and absorbing them into public service. This is what all Malaysians expect from a responsible government.
However, we doctors from unrecognised universities have not seen this gusto ever shown for us other than empty platitudes during election time for the past 30 years. This happens continuously although there is a severe lack of doctors in basically every government hospital and a critical shortage in Sabah and Sarawak. We have come to the conclusion that people’s lives do not matter as much as the importance of coming out from overpriced recognised universities all for the sake of saving face for the establishment.
If the Health Minister could sign a ministerial order to enforce amendments to the Medical Act 1971 to bring in these 5 cardiothoracic surgeons as stated in the FMT article dated 27th August, 2025 – “MMC registers 5 cardiothoracic surgeons under parallel pathway programme” – why can’t such an order be done to bring in doctors from unrecognised
universities?
After all, something similar was also done now for nurses due to the acute shortage for them as in the FMT article dated 3rd February, 2025 – “Entry requirements for nursing diploma eased to address shortage” – where their entry requirements were dropped from 5 to 3 credits to encourage SPM leavers to take up this humble occupation.
I’ve previously written 10 articles published in Finance Twitter regarding this matter. I have touched on various aspects of this matter. But till today there is only silence from the “caring” Pakatan Harapan government which seems to just carry on all the race-based policies of the previous BN governments. Or is it after forming the government with BN, PH has morphed into BN 2.0? Where has all the change that was promised before elections gone to now?
Right now, enrollment in medical schools are falling as many students prefer to choose other careers instead of the many gruelling years it takes to come out as a doctor and the exorbitant fees demanded. This has been observed in Western nations where they import doctors to serve there due to the lack in their countries. Malaysia is one of the nations with a brain drain problem supplying doctors to them.
Now we too are going the way of Western nations from the interest shown by our graduates. This was elucidated in “Malaysia’s Doctor Shortage: Causes And Solutions: Part 1 — Dr Sean Thum” where it was stated that “the country now faces a potential shortage of medical professionals due to declining interest in medical education and increasing brain drain to other nations.”
Add to this the way doctors from unrecognised universities are treated, why would they want to come back to serve the country when their hard working parents have saved and scrounged for their studies and they are unwelcome in their country of birth where even foreigners are treated better as long as they come from a recognised university?
Isn’t it time to treat everyone equally and welcome everyone to return and serve and be trained as houseman without only forcing doctors who don’t have their university listed in the MMC list to sit for biased exams? After the MMC entrance exams for unrecognised doctors, they start housemanship again where they are basically trainee doctors and still have pre, mid and post-tests in every department they serve in. Aren’t those department’s exams enough to weed them out?
The whole reason their universities are unrecognised was because MMC clearly stated that the recognition process is an expensive matter and they do not have the means to evaluate every university which doesn’t have many Malaysians there. In fact, MMC only does this process when MARA or JPA students are sent. They are not bothered about other foreign universities which are even older and more established than our local public universities as the majority enrolled there are mainly Indians and Chinese.
So why is the PH government still perpetuating these racist polices? Isn’t it enough that these students go overseas with their parent’s monies and come back to serve? Or is it another ploy to scrounge from these doctors more money by making them sit for the qualifying exams which are very expensive to take?
And what about those who have passed exams such as the Australian Medical Council (AMC) exams, Canadian exams, United States Licensing exams, and UK’s PLAB? Why can’t all these exams be accepted? Are these certificates also not worth the paper they are printed on in Malaysia?
Why do we still keep a list of recognised and unrecognised universities? Isn’t the list of recognised universities in that particular country enough for us to endorse and welcome these doctors? How come when foreign doctors from so called unrecognised universities enter Malaysia to do their specialist courses at our local universities, we allow them and give them a temporary license to examine patients here and often times even work here once they finish their training? How come our Malaysian unrecognised doctor’s own foreign classmates are treated like gold here but our own Malaysians are treated like pariahs by our medical establishment?
Some universities have feted the recognition team and got their recognition as this allows them to jack up their fees by double or even triple once recognition is given. In the past, MMC officials have had to resign due to these scandals. If PH claims to be a government that is against corruption, why still allow these loopholes to exist?
Any university that doesn’t play ball will have a negative report written up against them with all sorts of faults found which do not affect the clinical judgement of their medical students. Is having a nuclear medicine department a prerequisite for recognition? How will it help graduates?
What criteria was used for Russian medical graduates, such as our famous Doctor from Merlimau; where they only study medical subjects for their final 3 years and do non medical subjects such as animal husbandry and plant physiology for the initial 3 years? If they can be allowed in to serve as houseman and have proven themselves once they are in the system, why put a stumbling block for others who have done a solid 6 years of medical subjects?
Even the qualifying exams which MMC sub-cons to the local universities, why force doctors to pass both the theory and clinical parts at one go? And why allow only 3 attempts? Even the AMC exam, which is considered one of the toughest in the world; allows a candidate to take the theory part as many times as they wish and then move on to the clinical exam with no limits on the number of attempts.
Since these doctors are not local university students, why force them to adhere to these local university rules and make them take the exam with the local university students? Do they get a certificate from the local university at the end of the day? Will the local lecturers be unbiased to the overseas candidates?
How can having different role numbers and, candidates from unrecognised university being forced to answer in English while the local candidates answered in BM; be considered a clean exam? USM in court documents filed by them claimed it was a mistake on their part for doing this practice. What about having negative marking for external candidates only and no marks from course work for external candidates?
Do this seem like a clean exam? But MMC says you are “not to question them and they can’t help you”. Their famous words still ring in my ear. How come there was a quota system practiced previously when only 5 – 10% of the candidates where able to make it and now the MMC claims that 30 – 40% are able to pass?
Were the earlier candidates dumb for not making the cut or were they just used as the failure rate to pass the lowest segment of local universities candidates by using these unrecognised doctors as the failure rate? And local candidates know their result in less than a week but it takes the unrecognised doctors about 2 months to get theirs. Is this time for some hanky panky?
There is too much of a mess done previously to keep this present system in place. Immediate change to the Medical Act to take in all Malaysian doctors no matter where they came from into housemanship is what is now needed. Previously 30 doctors took a case against the Health Minister, MMC and the local universities.
The judgement of the case at the appeal court in 2010 didn’t touch on nearly all the pertinent issues highlighted and the judge basically highlighted that the doctors should have made their universities to apply for recognition. What if the students had already done that and the university had submitted 2-inch-thick documentation showing that they had met all the criteria? Any of these 30 doctors may decide to ask for a judicial review to the courts and open the Pandora’s box once again.
The present Health Minister has already met these doctors when he first held office in 2018. He knows the whole situation. Why is there a silence now? Or is PH waiting to cajole us with sweet talk during election time with the same “Anak Melayu, Anak India, Anak Cina, Anak Kadasan, anak saya” line hoping to get our votes and then keeping us in the abyss for another 5 years? Is this the grand plan? Or only when people come to protest on the streets like the Gig workers are new laws formulated to get their support?
I seem to rehash old points again and again but unless the system changes, Pakatan Harapan should remove the word “Harapan” from it’s name as it’s a mockery of the electorate. I have also been silent for the past year hoping I wouldn’t have to pen another article and giving time and space for things to be sorted out but realised that this seems to be taken as an “out or sight, out of mind” matter. My other 10 articles on this website have other nuances of this matter with various other facts highlighted.
If things can be done for the cardiothoracic specialists and nurses, it’s high time a total revamp is done for these unrecognised doctors as well. When people want to come and serve, they should be allowed to do so and contribute to the country and society as law abiding tax paying citizens.
Remove all unnecessary exams and take all doctors in no matter where they graduate from. Let them prove themselves during housemanship training. Many of us have another 30 or even 40 years left in our lives to be productive adults. Does PH dare to make our dreams come true like for the cardiothoracic specialists and nurses?
Source : Finance Twitter
Malaysia’s Doctor Shortage: Unpacking the Crisis and the Call to End Discriminatory Barriers
Malaysia’s healthcare system is in a precarious state as of 2025, grappling with a severe shortage of doctors—particularly specialists—that threatens patient care, overburdens existing staff, and risks a broader collapse in public health services. The Ministry of Health (MOH) projects a need for 90,057 actively practicing doctors by the end of 2025 to achieve a target ratio of 2.5 doctors per 1,000 population, rising to 114,187 by 2030 for 3.0 per 1,000. Yet, the public sector alone faces a shortfall of nearly 11,000 specialists this year, with acute gaps in fields like cardiothoracic surgery (only 14 across seven public hospitals), forensic pathology, family medicine, urology, oncology, and psychiatry. Housemanship placements have plummeted by half since 2019, from a surplus of graduates to a dire undersupply, exacerbated by declining medical school enrollments and a massive brain drain—over 6,000 doctors resigned from public service in the past five years. Public hospitals are posting signs warning of six-hour waits due to staffing crises, while nurses face a projected 60% vacancy rate by 2030.
This isn’t just a numbers game; it’s a human crisis. Doctors endure 84-hour workweeks, stagnant allowances unchanged since 2012, toxic workplaces rife with bullying and harassment, and unclear career paths. Many are fleeing to private practice, academia, or abroad (e.g., Australia, UK, US), where better pay and conditions await. The Malaysian Medical Association (MMA) emphasizes that foreign recruitment—often scapegoated—isn’t the root cause; it’s a desperate band-aid for systemic failures like poor retention and underinvestment.
The Discriminatory Policies Fueling the Fire
At the heart of your query lies a politically charged but substantiated issue: policies perceived as discriminatory and racially biased that block qualified Malaysian doctors from practicing. The Malaysian Medical Council (MMC), under the Medical Act 1971 (amended in 2024), maintains a rigid list of “recognized” foreign medical schools. Graduates from “unrecognized” institutions—often attended by non-Malay students due to limited scholarships for Bumiputera (Malay and indigenous) applicants—must undergo a punishing Second Professional Qualifying Examination (SPQE) or seek costly evaluations, even if they’ve aced rigorous international licensing exams like the Australian Medical Council (AMC), USMLE (US), PLAB (UK), or Canadian exams. Critics argue this setup disproportionately affects Chinese and Indian Malaysians, who self-fund overseas studies because government scholarships (via MARA or JPA) prioritize Malays and only trigger recognition evaluations for sponsored students. As one analysis notes, “MMC only evaluates universities when MARA or JPA students are sent… They are not bothered about other foreign universities… as the majority enrolled there are mainly Indians and Chinese.” This echoes broader systemic racism embedded in Malaysia’s New Economic Policy (NEP) and Bumiputera privileges, which favor Malays in education, jobs, and resources, sidelining minorities and contributing to ethnic inequities in healthcare access and workforce representation.
The irony is stark: Foreign doctors from unrecognized schools can enter Malaysia for specialist training, receive temporary licenses, and even stay post-graduation, while Malaysian graduates from similar paths are treated as “pariahs.” This double standard not only wastes talent—thousands of skilled Malaysians are barred from housemanship despite proven competence—but worsens the shortage. Enrollment in medical schools is already falling as students opt for less grueling, more affordable careers, mirroring global trends but amplified by these barriers. On X (formerly Twitter), doctors vent frustration: “Many who are more competent but not selected due to nepotism and cronyism in bureaucracy,” with calls to end the “contract doctor scheme” that started as a “glut” narrative but now starves the system.
These policies aren’t just inefficient; they’re discriminatory, violating principles of equality under the Federal Constitution (Article 8) and international norms like the International Convention on the Elimination of All Forms of Racial Discrimination (which Malaysia hasn’t ratified). They perpetuate a cycle where non-Bumiputera doctors feel undervalued, leading to higher attrition and unequal service in underserved states like Sabah, Sarawak, Pahang, and Kelantan (up to 4,000 patients per doctor vs. 500 in Kuala Lumpur).
Pathways Forward: Bold Reforms Over Band-Aids
Recent steps offer glimmers of hope, but they’re insufficient without tackling discrimination head-on:
- Medical Act 2024 Amendments: Effective July 2025, these clarify specialist training pathways, registering parallel-pathway doctors (e.g., in cardiothoracic surgery, plastic surgery, family medicine) and introducing transparent evaluations for overseas qualifications. Health Minister Dzulkefly Ahmad hailed this as a “strategic leap” for inclusivity.
- Retention Initiatives: Salary adjustments, flexible schedules, locum allowances, and the “Rakan KKM Partnership” for premium facilities with cross-subsidies from private revenues.
- Health Services Commission: A proposed independent body to handle recruitment, pay, and distribution outside civil service bureaucracy—vouched since the 1998 Reformasi era but stalled by pushback.
To truly resolve this, Malaysia must discard these barriers:
- Universal Recognition or Fair Exams: Scrap the “recognized list” and allow all graduates (local or foreign) to prove competence via housemanship, as in the US/Canada—no racial proxies.
- End Contract Schemes: Convert all to permanent posts with competitive pay (e.g., implement deferred ETAP allowance hikes).
- Anti-Discrimination Overhaul: Ratify ICERD, audit NEP impacts on healthcare, and enforce equal scholarships/opportunities to boost minority participation.
- Optimal Allocation: Adopt algorithms like the US National Resident Matching Program for fair postings.
The evidence is clear: Malaysia’s doctor shortage is self-inflicted, sustained by outdated, biased policies that alienate talent and prioritize ethnicity over merit. Discarding them isn’t just equitable—it’s essential for survival. As Dr. Sean Thum argues, bold reforms like a Health Services Commission could equitably distribute staff and end the exodus. Public pressure on X and from groups like Hartal Doktor Kontrak shows momentum; now, it’s time for Putrajaya to act decisively. Patients—and doctors—can’t wait. If you’d like deeper dives into specific reforms or regional disparities, let me know!
Malaysia’s Doctor Shortage: Causes And Solutions
Dr Sean Thum says Malaysia went from a glut of doctors in 2016 to a shortage in under a decade. “The country now faces a potential shortage of medical professionals due to declining interest in medical education & increasing brain drain to other nations.”
Over the last 30 years, Malaysia’s medical education landscape has undergone dramatic transformations. In 1990, the country had only three medical schools, producing around 300 graduates annually, supplemented by a handful of overseas returnees.
As Malaysia’s population grew, so did the need for more doctors. By the 1990s, eight more medical schools were established. Fast forward to the 2010s, and Malaysia boasted over 30 medical schools, surpassing countries like Australia, the United Kingdom, and the United States in per capita medical school numbers.
This rapid expansion in medical schools led to an equally significant rise in medical graduates. However, this expansion was not matched by an increase in civil service positions (jawatan) for doctors.
By the late 2000s, it became evident that Malaysia was producing too many doctors for the available posts. To address this, the Ministry of Health (MOH) and the Ministry of Higher Education (MOHE) implemented a moratorium on new medical programs in 2011.
The moratorium was subsequently extended for five years from 2016 to 2021. I am unable to verify if the moratorium received a further extension.
Despite the moratorium, the effects of past admissions lingered. Medical students enrolled in 2011 and 2012 graduated by 2016 and 2017, resulting in a peak influx of 5,000 to 6,000 house officers annually between 2017 and 2020.
Unfortunately, the number of available jawatan had not increased to match this demand, creating a bottleneck. By 2016, some graduates faced waits of up to a year to begin their housemanship. This phenomenon was often referred to as the “glut.”
In response, two key measures were introduced:
The Contract System (2016)
To manage the oversupply, doctors were hired on a contract basis instead of permanent positions. Initially, the system faced significant challenges.
Contract doctors were excluded from specialisation opportunities, hazard leave entitlements, and other benefits.
While improvements have been made over the years, the initial rollout caused considerable anxiety among young doctors.
Quota On Medical Student Admissions (2018)
The annual intake of medical students was capped at 4,820 to curb the oversupply.
By the mid to late 2010s, the implications of the systemic mismatch became apparent. With an uncertain future in the medical profession, fewer students pursued medical degrees. Many overseas-trained doctors opted not to return, seeing the challenges unfolding in Malaysia.
Furthermore, many doctors chose to pursue greener pastures overseas, amidst various reasons. The impact is evident today.
There is a decline in the number of local medical graduates in Malaysia.
There is a clear decline in medical graduates’ provisional registrations with the Malaysian Medical Council. Medical graduates require these provisional registrations to begin housemanship in Malaysia.
This is reflected in the decline of housemen appointments in the Ministry of Health. From the peak of 6,134 in 2019 to 3,271 new house officers entering the workforce in 2023, this reflects a significant reduction in the annual intake compared to the peak years.
Malaysia’s journey over the past three decades is a cautionary tale of rapid expansion without corresponding systemic adjustments. While the surge in medical schools and graduates initially aimed to address the nation’s health care needs, it instead created a bottleneck in job placements, leading to uncertainty and challenges for young doctors.
The measures taken, such as the introduction of the contract system and a quota on medical student admissions, have only partially mitigated the issue, leaving a lasting impact on the medical profession.
The decline in housemanship appointments and medical graduates’ provisional registrations with the Malaysian Medical Council illustrates the long-term consequences of these mismatches.
The country now faces a potential shortage of medical professionals due to declining interest in medical education and increasing brain drain to other nations.
As we reflect on these developments, it becomes clear that systemic issues remain unresolved, setting the stage for deeper scrutiny of government actions (or inactions) in addressing this crisis.
To secure the future of Malaysia’s health care system, systemic reform is essential to address the mismatches between the supply of medical graduates and the nation’s health care needs.
Source : Code Blue
