Ending the era of contract doctors by 2028

From Moaz Nair

The government’s phased initiative to dismantle the contract system for medical officers by 2028 under civil service reforms is a commendable stride forward.

The health ministry's Inter-Ministerial Joint Task Force (IMJTF) targets that, by 2028, every single graduate medical officer (houseman) who completes training will be offered a permanent role immediately.

Alongside plans to absorb remaining contract doctors in waves throughout 2027, this milestone stands to dissolve years of systemic gridlock.

Various measures have also been introduced to encourage more young medical officers to serve in Sabah and Sarawak. These initiatives include improving the placement system, fully covering relocation expenses, and granting additional merit points for specialist training and study leave applications to those deployed in the two regions.

However, if the ministry truly wants to eradicate career uncertainty for young doctors, it must maintain momentum through absolute policy transparency. Permanent job security means little if the job itself remains structurally unsustainable.

The underlying crisis

Securing a permanent position is no longer the ultimate retention tool it once was. The ministry faces an ongoing talent drain, as permanent medical officers continue to resign due to acute workforce pressures.

Chief among these triggers is the operational environment. Extreme workloads and severe burnout—compounded by gruelling on-call hours and systemic understaffing at key facilities—are directly eroding the mental and physical well-being of frontline officers. A toxic workplace culture, notably the persistence of bullying, further compromises their emotional health.

This structural stress is intensified by friction within the e-Placement system. Abrupt, ill-prepared regional transfers, combined with historical inequities in relocation allowances, have frequently left physicians feeling trapped, viewing resignation as the only reasonable exit strategy.

When coupled with personal sacrifices—whether managing family logistics, navigating chronic health challenges, or funding independent specialist pathways—the public healthcare system becomes increasingly difficult to justify for young talent.

Strategic roadmap for systemic retention

To preserve the integrity of our national health service, the state must match its hiring pledges with deep, structural interventions:

Restructuring financial rewards: the government must bridge the income gap between the public and private sectors through periodic reviews of salaries and allowances. This measure includes reassessing the critical service allowance, increasing on-call allowance rates, and introducing specialised incentive models for senior clinical specialists. Furthermore, extending fair locum payment rates is essential to ensure that every hour of overtime is met with commensurate financial compensation.

Reforming workplace culture: the ministry must shift from rhetoric to strict enforcement regarding its zero-tolerance policy against hospital bullying. Introducing humane, flexible scheduling is a prerequisite to mitigating chronic burnout.

Transparent e-Placement logistics: the e-Placement mechanism must operate with predictability, affording doctors reasonable notice windows to arrange their personal lives. Incorporating voluntary placement options or regional preferences would heavily boost morale. Crucially, full relocation allowances must be distributed equitably across all tenures to curb the financial shocks of interstate transfers.

Securing specialisation pathways: access to advanced postgraduate tracks, whether via the federal training award (HLP) or parallel pathways, must be expanded and streamlined. Young physicians need to see an unambiguous, rewarding long-term trajectory within the public civil service.

The bottom line

Retaining our public medical workforce goes far beyond baseline worker welfare; it is a critical investment in the sovereignty and resilience of Malaysia’s healthcare framework. The resignation trends tell a clear story: toxic environments and career instability are the primary drivers of our talent flight.

By balancing the 2028 permanent employment pledge with meaningful, systemic workplace and financial updates, the ministry can successfully turn the tide. Safeguarding a competent and motivated healthcare workforce is the only definitive way to ensure every Malaysian retains access to equitable, high-quality and affordable care.

Moaz Nair is an FMT reader.

The views expressed are those of the writer and do not necessarily reflect those of FMT.