KUALA LUMPUR – Making doctors’ positions permanent will not, by itself, resolve Malaysia’s doctor shortage unless the government also tackles excessive workloads, burnout and limited career progression, says public health medicine specialist Assoc Prof Dr Aidalina Mahmud.
She said permanent employment would provide doctors with greater security to plan their careers, pursue specialist training and manage family commitments. However, converting contract positions into permanent posts would not necessarily increase the number of doctors available to treat patients.
“A doctor already serving in a government hospital does not become an additional doctor simply because their appointment becomes permanent,” she told Scoop.
Aidalina, who heads the Health Service Management Unit at Universiti Putra Malaysia’s Department of Community Health, said the initiative’s effectiveness would depend on how many doctors accepted the offers, reported for duty and continued serving in the public healthcare system.
“The real benefit will depend on how many accept the offers, report for duty and remain in service. We must also account for those leaving,” she added.
She said staffing requirements should be evaluated according to the actual demands at individual healthcare facilities, noting that a favourable national doctor-to-population ratio could mask shortages at hospitals struggling to maintain adequate duty rosters.
From a health management perspective, Aidalina said the government should establish whether each facility had sufficient personnel to meet its workload instead of relying solely on national staffing figures.
Better working conditions key to retention
Aidalina said permanent appointments must be accompanied by fair remuneration, manageable workloads, sufficient rest, supportive supervisors and credible opportunities for career advancement if the government wants to retain doctors.
“Permanent positions give security, but doctors also need a working life they can sustain,” she said.
She added that addressing burnout required more than counselling, as the workplace conditions contributing to doctors’ distress also needed to be improved.
One measure she proposed was introducing confidential “stay interviews” to identify workplace problems and understand what would persuade doctors to remain in public service before they decided to resign.
Departments experiencing repeated resignations should also undergo management reviews to uncover underlying issues and ensure corrective measures were taken.
“We should expect managers to take responsibility for retaining staff, just as we expect them to deliver services,” she added.
Rural postings need stronger support
On the distribution of young doctors, Aidalina said clearer career pathways after housemanship could make public service more attractive.
She said placements in rural and underserved areas should be planned according to workload, population needs, travel distances and access to referral services.
Doctors assigned to these locations should receive adequate accommodation, relocation assistance, senior supervision, continuing education and transparent transfer arrangements, she added.
Aidalina also called for rural service to be recognised in career advancement and training opportunities through fair, publicly available criteria.
“Sending a doctor to an underserved area is only the beginning; keeping a supported, functioning team there is the real achievement,” she explained.
Measure outcomes, not just appointments
Aidalina said the government should assess the initiative through indicators including acceptance rates, the number of doctors reporting for duty, retention after one and two years, vacancies, overtime and working conditions.
These measures should be evaluated alongside patient outcomes to establish whether the policy had genuinely strengthened the public healthcare workforce.
She said regular updates on these indicators should be published to enable the public to determine whether the appointments were producing meaningful improvements.
Ultimately, Aidalina said the priority should be to build a stable healthcare workforce capable of delivering safe and timely treatment, rather than judging success solely by the number of permanent offers issued.
During the tabling of Budget 2027, Prime Minister Datuk Seri Anwar Ibrahim announced that 9,000 doctors would be absorbed into permanent positions next year.
He also said doctors completing their housemanship would be offered permanent appointments beginning in 2027. – October 19, 2026