Help contract doctors have better futures

I REFER to the statement by the Academy of Medicine of Malaysia (AMM) recently regarding creating more permanent medical officer posts to satisfy demands for specialists (“Ensuring we have enough specialists”, The Star, Oct 22; online at bit.ly/star_specialists). The plight of contract medical officers has been debated extensively over the last few years. Despite the efforts made by multiple agencies to ensure a better future for contract doctors, the matter has yet to come to a satisfactory conclusion.

The contract system was first introduced in December 2016. Since then all medical graduates have been employed under a contract with no clear disclosure of what the long-term plans are for these doctors. To make matters worse, there is also a difference in civil service grades between UD41 contract medical officers (MOs) and UD44 permanent MOs, the consequences of which include a differential in annual salary of nearly RM8,000, and a lack of unrecorded child care leave and hazard leave for contract MOs in departments like radiology and psychiatry. All this despite having the same workload and responsibilities as their fellow permanently employed colleagues.

To add insult to injury, the hadiah latihan persekutuan (federal training grant), which is a full scholarship provided by the Health Ministry for doctors to pursue specialisation in local public universities while working, is only available to permanent MOs.

It is imperative to make changes to the current conditions of the contract system for MOs and the training grant, as contract doctors are not eligible for local postgraduate specialisation courses even if they are self-funded. The current specialisation training pathway in Malaysia is almost entirely dependent on the Health Ministry’s hospital system and the training platform of universities. As a result, MOs completing their housemanship training have no clear path into specialty training and may be unemployed by the end of their contract, as private hospitals commonly only hire specialists.

As mentioned by AAM, it is crucial that we recognise the shortage of specialists in Malaysia. We are currently facing a scarcity of specialists with only 3.9 specialists for every 10,000 head of population (as of June 30) compared with the OECD (Organisation for Economic Cooperation and Development) average of 14.3 specialists to 10,000 head of population in 2018. It is vital that we keep in mind that of those specialists, most are concentrated in major cities in Malaysia and that we are still lacking subspecialists in many areas.

We applaud and greatly appreciate the efforts of the AMM in encouraging postgraduate training through other avenues such as the EMP (e-training management) platform. This suggests that we are able to provide the channels to ensure better career prospect for our junior doctors. We implore the government to aid the plight of contract doctors, who are essentially the frontliners who are keeping the healthcare system afloat during this Covid-19 pandemic.