Bleeding talent: Why Malaysia's doctors are leaving

Malaysia’s public healthcare system is facing a quiet crisis. Every year, thousands of highly trained doctors resign from public service, creating a severe Malaysian doctor brain drain that threatens the nation's health security. Between 2019 and 2023, 6,417 public medical officers, including over 1,000 specialists, left their posts.

The constant departure of doctors has become a systemic hemorrhage of talent. A combination of policy failures, chronic underinvestment, and a punishing work culture fuels the problem. Breaking down the real push factors Malaysian doctors face reveals what this means for the future of healthcare in Malaysia.

The 'Hartal Doktor Kontrak' system: A promise unfulfilled

The contract doctor issue in Malaysia is a primary cause for the mass resignations. Introduced in 2016 to manage a surge of medical graduates, the system created a discriminatory two-tiered workforce. Young doctors were hired on short-term contracts with lower pay, fewer benefits, and critically, no clear path to a permanent position.

The numbers tell a stark story. Between 2016 and May 2021, of the 23,077 doctors hired on contract, a mere 3.4% were given permanent posts. The policy left thousands in a state of professional limbo, unable to plan their futures or pursue specialisation. 

Stagnant wages and low compensation

A major driver behind Malaysia’s doctor brain drain is the fundamentally uncompetitive pay. The salary in Malaysia for a junior doctor in the public sector is around RM3,500 (USD832) per month. In contrast, their counterparts in the UK earn an equivalent of over RM13,000 (USD3,089), and those in Singapore or Australia earn two to three times more.

The disparity becomes a chasm for specialists, who can earn ten times more in Singapore's public sector than in Malaysia's. Feeling undervalued compounds the financial pressure. The on-call allowance, for instance, has remained stagnant for a decade, breaking down to a rate of just RM9.16 (USD2.18) per hour—less than many part-time jobs. 

According to the Malaysian Medical Association (MMA), a requested raise would cost a relatively modest RM80 million (USD 19 million) annually, a figure that pales in comparison to other government expenditures.

Burnout is real: Overwhelming workloads

Beyond pay, the working conditions for doctors in Malaysia are simply unsustainable. It's common for doctors to work up to 84 hours per week, enduring grueling on-call shifts that can last 33 hours straight. Chronic understaffing fuels the culture of burnout. As more doctors leave, the patient load is redistributed among those who remain, creating a vicious cycle of fatigue and more resignations.

The problem extends beyond long hours. Doctors are often burdened with heavy administrative tasks that take them away from patient care, contributing significantly to job dissatisfaction. Such extreme professional strain has tangible consequences, leading to high rates of burnout and compromising patient safety.

Limited opportunities for career growth

For ambitious professionals, a clear career path is essential. The contract system created a severe bottleneck for postgraduate training, effectively blocking the vast majority of junior doctors from becoming specialists. For a profession where 85% of entrants aspire to specialise, the policy was a devastating blow.

The uncertainty and bureaucratic hurdles have made overseas opportunities far more attractive. Many are asking why Malaysian doctors are moving to Singapore, Australia, and the UK, and the answer is simple: these countries offer structured, transparent, and accessible specialisation pathways. The message from Malaysia's system has been clear: your ambition has a ceiling here.

What can be done to reverse the tide?

Solving this crisis demands bold, structural reform, not small adjustments. The solution to how to solve doctor shortage in Malaysia involves several key actions:

• Abolish the contract system: The first and most crucial step is to end the two-tiered system and offer all new doctors permanent positions with equitable pay and benefits.

• Comprehensive salary reform: The government must conduct a serious review of physician salaries to make them competitive with the private sector and neighboring countries. Immediately increasing on-call allowances would be a powerful show of good faith.

• Improve working conditions: Enforcing safe working hours and investing in more support staff to reduce the administrative burden on doctors is essential to combat burnout.

• Create clear career pathways: Expanding specialisation opportunities and ensuring the process is transparent and merit-based will give doctors a reason to build their careers in Malaysia.

The haemorrhage of medical talent is a direct threat to the health of all Malaysians. It leads to longer wait times, a critical shortage of specialists, and poorer health outcomes, especially in rural areas. Reversing this trend requires a fundamental acknowledgment: investing in doctors is a critical investment in the nation's future.