I wrote my last article on 29/10/2019, throwing a question whether our junior doctors are facing a tragedy or a comedy. I modified the sentence, from the highest grossing R-Rated movie of all time, currently playing in cinemas: JOKER. “I use to think that my life was a tragedy, but now I realised it’s a comedy”. In that article I explained the letter issued by MOH dated 30/09/2019 on the status of floating doctors. I said, those who receive an extension of contract will likely see their final journey in civil service. The end of that contract will be their end of a job in civil service. It looks like my interpretation of the letter was subsequently confirmed by our Health Minister in the Parliament, just 2 days later, on 31/10/2019:
He has also quoted some interesting figures during his answer in Parliament. As of 31/08/2019, we have 15 246 contract officers! In 2019 alone, we have 4 202 new contract officers and 2 515 are waiting to be appointed between November 2019 to February 2020. This figures are nothing unexpected. Since I started this blog, I had warned that this is going to happen. I first raised this issue in 2006 when I wrote an article to MMA Magazine . The mushrooming of medical schools without proper human resource planning will only lead to disaster. I have spoken about this for umpteenth years and thus I would not go into it again. We are producing about 4-5 000 graduates per year (35 medical schools locally and from overseas) when we have already reached a doctor: population ratio of 1:580 last year! The peak has not even arrived! The idea of contract post has a 2 prong strategy. Firstly, you can kick out those who are not performing and another is to allow you to complete your housemanship and compulsory service. This is similar to any developed country, jobs are never guaranteed but they will provide you with an internship post under contract as it is a statutory requirement to be eligible for full registration. However in Bolehland, transparency has never been in their dictionary. Below is a circular that was issued some time ago on how they expect to evaluate those who will receive permanent post and those who will receive a contract extension. REMEMBER, ultimately it also depends on availability of permanent post, as I wrote in 2016.
In June 2019, the first batch of contract housemen (who completed housemanship in December 2018) received their long awaited letter from KKM…….
While almost 1000 applied, only about 500 received permanent post and about 50 received extension of contract. In September, I heard another 175 received extension of contract. As per the letter above and my previous article, those who received permanent post got transferred “mengikut keperluan”. The worst is yet to come! Two days ago, I received information via this blog that those who got the extension of contract just received their official contract 2 weeks ago. The contract is extended from 5/12/2019(the day the first 3 years contract ends) to 4/12/2021 which is another 2 years. So, the total contract years will be 5 years. The shocking part, which I never expected was the fact that THIS CONTRACT KEEPS THEM AT THE SAME PAY GRADE AS A HOUSEMEN, WHICH IS U41, contrary to my understanding that it should have been U44 !!!
Yes, before the year 2010, most of us will remain in U41 (or U3 as it was known before 2001) for few years after completing housemanship with just annual increment. But in 2010, under the new promotional prospect for doctors in civil service (which I personally wrote during a SCHOMOS forum with KKM in 2006) , all those who complete housemanship will be promoted to U44 from the day of receiving full registration. While those who received permanent post got promoted to U44, those who receive contract extension seem to be “dianak tirikan ” ……………..
I find this totally atrocious! If a person is going to work as a medical officer and doing the same job as another permanent U44 officer, they should receive the same pay! Yes, they should thank their lucky stars that they have a job but we should never discriminate them by paying them lower than the rest. Unless you are transparent enough to say publicly than these guys had such a poor performance that they are not fit to hold a U44 post( that we are just doing a charity work by extending their contract to complete their compulsory service), everyone should be treated the same. Under labour law, can this be considered “forced labour”? BTW, our country’s international standing in labour law is not that great either.
For those who are unaware, SPA/JPA has been requesting to remove compulsory service over the past few years as they know they can’t provide jobs to everyone. However, it will be a disaster to do so, with many having a license to kill, out there. Completing housemanship do not make you competent enough to manage patients without any supervision. MMC has refused to comply to their request as it affects public safety. MMC’s motto is ” safeguarding patients and guiding doctors”. That’s why compulsory service is important, not just to comply with legal requirement but also to make you competent enough to practise on your own.
Whatever said, we should accept the fact that no job is guaranteed. No government guarantees you a job either. People should not assume that just because they are spending RM 500K to make their child a doctor, your investment is going to produce a guaranteed job and tons of money/return. Those eras are gone for good. However, these poor souls became a victim of poor human resource planning (which does not exist in Bolehland dictionary) and a capitalist world where commercialisation of medical education became a money making business!
I was also informed that from now onwards, the number of floating doctors who will receive permanent post will further decline due to availability of post. Remember, 15K is waiting in line! BTW, please be informed that compulsory service is only for 4 years ( 2 years HO and 2 years Mo), so you can leave before you finish your 5 years (after a total of 4 years). The question is : to where? Some can consider university hospitals but they too have their limits. Not to mention that contract officers are not entitled for Master’s program and banks will think twice before giving you a loan.
Basically, those who are being extended under contract will be paid under U41 salary but will end up doing the same job as a U44 MO, with their life in civil service ending in 2 more years. Again……..
IS THIS A TRAGEDY OR A COMEDY……………..
Pagalavan's Avatar 
You have taken your valuable time to time to explain the full detail.Thank you very much.
This is a tragedy and thats why i quit on staying in Kkm. It is like invitation for you to be a labour in a company while you and i know we are not wanted
Any parent wanting to put his/her child into the medical program must stop that foolish thought now.After spending RM500,000 and the medical graduate ending up as a Grab driver will be the biggest tragedy . This is coming already. Those who read these articles are blessed to know what is coming.
Thanks very much for the effort and time in gathering information on this matter. That includes helping the graduates who are in this situation . It will indeed serve as guidance for present and future medical graduates. Hopefully, they can chart their career path, knowing the risks involved.
[…] Letchumanan, a consultant physician and rheumatologist at Columbia Asia Hospital Nusajaya, wrote on his blog yesterday that in the first batch of contract housemen who completed their two-year housemanship in December […]
Hi guys. I see things have gotten worse since I’ve moved to Australia 4 years ago. I still keep up with the news back home via Dr Pagas blog. I graduated in 2009 and spent 7 years in government service before I saw that Malaysia will not progress beyond its affirmative action policies. The current PH government is just copying what BN is doing. That aside. My advice to those who have full registration and on a contract is this: you’re at the whim of a government that doesnt care about your career. Save money and sit for amc part 1. Apply to regional areas. There is a major shortage as their people would not want to work there. It isn’t that rural I assure you. Youd be earning their money and sit for part 2 while you’re here. But here is the catch. It would be difficult to enter surgery or orthopaedics. You can try but don’t put your hopes up. It will give you an option to work in australia and build a life here. I passed my AMC exams in 2018. It’s not easy by a long shot. The passing rate is 20% at best. But there are a lot of resources out there that can help improve your chances.
The Australian government has tighten the rules since March this year if you are aware. Currently, Australia is also reducing their intake of foreign doctors. They have also reclassified what is rural for IMG intake as far as GPs are concerned. It is getting really rural, unlike the previous DWS areas. Even physician training is getting tough to enter and the number of applicants are increasing yearly.
I agree Dr Paga with what you said. It’s true but the window is not closed yet. The town which I practiced at last year was as big as Seremban. It’s classified as a regional DWS area. So worth looking at for those interested
That would be a non-DPA(the new classification) by now. Which means, IMG won’t be able to work. Even Geraldton, Mandurah and Bunbury in WA is now considered non-DPA. Please look at the new DPA criteria and locations with came into force on 1/07/2019. I was surprised as well.
lol “Dr” Kelvin Yii giving his opinion about the future of health care in our country? He didnt even finish housemanship back in 2011. He dare call himself doctor. so funny
Hi dr. What do you think of the working opportunities in the UK? Is there a guaranteed job in the UK after PLAB?
No job is guaranteed. Even if you get, it will be a non-training post in rural or seminal areas.
The present UK government had announced that they will introduced a new NHS Visa to fast track overseas doctors and nurses to work in the UK.
https://www.freemovement.org.uk/new-nhs-visa-announced/
https://www.itv.com/news/2019-11-08/johnson-unveils-nhs-visa-to-attract-top-medical-talent-to-uk/
Probably, your medical qualifications and experience have to be recognised by the UK GMC and you must have a good command of English. The scheme is expected to come in force in 2021. This might mean that Malaysians who graduate from UK medical schools would be able to stay back and work there.
Your degree must be recognised by GMC. Even before this, those who graduate from UK universities can continue with the internship and job in UK. That has never changed. Otherwise you need to sit and pass the PLAB exam.
Hi dr. What do you think of the working opportunities in the UK? Is there a guaranteed job in the UK after PLAB?
Dear Dr Pagalavan,
Do you have any news as to even for those who got absorbed into the permanent system, from when does their UD44 pay start?
What i mean is: as you mentioned earlier, previously one was entitled to receive UD44 pay once he/she got his/her permanent MMC registration, even during the floating period. But now, we floated for 7.5 months – as a CONTRACT floating MO – hence are we still entitled for UD44 pay in the 7.5 months of floating? Or does the UD44 pay start from the day we start as a permanent civil servant?
Thank you.
I was informed that those first batch who got permanent post are still waiting for the official letter from SPA (despite already transferred and started work). They were told that their U44 will be backdated to date of full registration. We still have to wait and see.
What I don’t understand is why are we still sending students overseas when we don’t have even have enough posts for our own local graduates
JPA has stopped since 2016. Most who go overseas now are self sponsored and some MARA students
It is the same everywhere. Government permits developers to build as many condos as possible. Suddenly you find a RM42 billion property overhang few years later.. Same with medicine. Each new Minister comes and doles out licenses. Many private Universities offering medical programs. Suddenly you find too many doctors around. Poor planning, over enthusiasm and greedy people. Sending overseas is a prestigious matter. Must send some students overseas for political reasons.!
JPA has stopped sending students overseas for medicine since 2016. I think MARA still does.
Well, I chose to leave KKM because of this stupid system which does no appreciate their workers. I don’t think I need to say anything about the work environment lah. Paid peanuts to work endlessly with high burden/stress. I know some will say “appreciate that you have a job!”, but that person can come to me to receive a personalized slap to the face(may contain peanuts).
Anyway, this broken medicine field in Malaysia needs a big overhaul. We are not progressing with technology. Sureeeeee, we get new equipments once in a while. And we have computers(high tech apparently). But our system is shit to the core. Wrong focus of training, wrong division of labor, BAD MANAGEMENT FROM TOP TO BOTTOM, just to name a few la. Just because your old times can, does not mean it should be done now. It’s like they strive to make life harder for everyone just to get back at “the past”. These “sentimental retards” should just die.
Lol, turned into a rant in the end. It wont end with a paragraph if any of us starts revving up. Yeah. F medicine and F all the toxic useless idiots. If I find a genie who will grant me a wish, I would wish for an extra pair of arms so I can flip these people x2.
Welcome to Malaysia! Did you forget that you were in Bolehland? BTW, the situation is not that rosy either in other countries. That’s why I keep saying never do medicine for wrong reasons.
The UK has opened up all medical specialties post graduate training leading to UK CCT (consultants qualifications) to worldwide doctors meaning that anyone with MRCP UK can apply. And everyone is on equal footing. This is because NHS has lost many doctors after Brexit, and local doctors are not keen to do training, but extra hours at very high hourly rate as staff grade doctors. If any of your colleagues is interested, you may share with them. This opportunity may not last forever. Link as follows.
All medical post-graduate training programmes are no longer subjected to Residency Market Test. Once accepted into a training programme, if 5 years duration, then the doctor qualifies for Indefinite Leave to Remain in the UK, so does their married partner and children <18 years
Ref: https://www.nhsemployers.org/news/2019/10/shortage-occupation-list-changes-now-implemented
Useful links
https://omarsguidelines.blogspot.com/2019/10/how-to-get-training-post-in-uk.html
https://naseersjourney.com/useful-links/
http://omarsguidelines.blogspot.com
Doctors in UK did not leave because of Brexit as Brexit has not taken place yet. It is because of the overtime pay cut in 2016. Many left to Australia, NZ, Canada etc.I have spoken to some of them. Trust me, their workload is as bad as our KKM hospitals. That’s why they seem to be having some shortage, it’s a short term issue. And you will only get non_training post first and eligible to apply for training post after 1 year.
And surg/orth trainee with MRCS? Wait idly for masters which is not transparent and very politicky (need to butter a few important bosses) or go to UK and go thru the ST3 and finish up with CCST?
Masters take 4 years. 1 or 2 years to enter if we say now for mrcs holders.
That makes 5 or 6 years. Can also take frcs exit exam as a private candidate if one is ambitious enough.
Go to UK. Apply a non training registrar post. Work for 1 or 2 years. Apply AST post. Another 5 years for FRCS.
That makes about 6 more years minimum.
Disgarding family issues aside, is it a better and more viable path?
*tired of politics*
The issue that people don’t realise is, even in UK, there is no guarantee that you will get a training post as planned. I know a few who had to return back to Malaysia as they could not get into the training program after several attempts. So, it is a risk that you have to take, not to say it is any easier/faster than in Malaysia
https://www.theguardian.com/society/2019/may/12/malaysia-gp-home-office-pushing-away-foreign-nhs-doctors
https://www.theguardian.com/society/2019/may/12/hundreds-of-foreign-doctors-mull-leaving-uk-over-crippling-fees
That is another important reason why foreign doctors leaving UK… Too much fees to pay !
As for the selection of contract HO into permanent post , the criteria seems keep changing . Initially there was a dialogue in between KKM HO and deputy DG , chaired by MMA , it was mentioned that extension of any cause will be deemed as competency issue , which hinders absorption into permanent public service
However , in the latest guidelines circulating around, such criteria was not specified .
Any Ex HO who did not ever extended but still not able to get into permanent public post ?
I think the first and foremost criteria is availability of post. Yes, those who finish HO in December 2018, all finished on time but some still got contract extension.
Furthermore . KKM did not further elaborate what are the criteria for the selection of Contract MO into permanent service . Some even got the Membership entrance examination without getting extended . With this kind of system , specialist training will be affected due to contract HO cannot join parallel pathway even they passed the membership examination .
KKM should offer permanent post directly to those who got the Membership entrance examination , allow them to join the parallel pathway earlier. Not waiting for another 2 years .
Dr Dzulkefly defended the government `s decision to pot MOs on contract during their entire two-year mandatory service with the government.. He said the ministry is NO longer able to absorb every single medical graduate as it is subject to available vacancies at hospitals. (FMT 9/11/2019)
Yup, he just confirmed what I have said!
The reality that is pictured here in this blog is hard to swallow but we have to face it. Just came home talking to some relatives of mine. They are still thinking of medical programs for their children. What can I say.?
They will not listen to you! Period. They don’t understand the problems with medical degree
During the media press which was published on FB by KKM , DG mentioned that contract MO still allowed to join the parallel pathway . However , the details of it was not mentioned as no further questions on it later .
Very interesting scenario .
If a contract MO already got part 1 membership examination and start doing parallel pathway (provided they are allowed to do so ) , shouldn’t government provide them permanent post as well ? If government still unable to provide post for these group of people , means u can be kicked out from service even you are halfway doing the specialist program ! Unless the government can guarantee you a permanent job .
Details on promotion of contract MO into permanent MO was not further elaborated .
Yup, i felt the answer was ridiculous. In order for you to complete the parallel pathway, you need to be in service. So, if your contract is going to end soon, how are you suppose to complete the pathway?
Hope our good Doctor can reconfirm the following points:
1. The number medical graduates entering the market is about 4,000 to 5000 each year.
2. Waiting period now is 12 months but will go beyond this next year on wards.
3. Drop out rate for housemen is around 30% to 40%.
4.All housemen will undergo 2+1 system. Two years houseman plus one year for extension.But you will be under contract for 3 years. Extended by another year to 4 years.
4. Absorption rate into permanent service is very low. Those who cannot complete their houseman in two years have a slimmer chance of being absorbed. So try not to be extended.
5. The criteria for absorption – no one knows as it keeps changing daily.
6.When you complete your houseman successfully, you will be given a new placement. But not made an MO yet. And your salary is still UD41 grade
7.The official letter making you an MO will come maybe six or nine months later. With that letter comes a new placement. Transfer again or quit! So it is possible you may need to transfer to 2 different places in just one year.
8. Mind you,with the letter, you are still under contract for another 2 years. Not made permanent yet. Will there be an upgrade. Yes. When? Only God knows. They will backdate your pay but back-pay will come only when the Government has the money to pay you.
9. Can I try overseas? All countries have their qualifying exams to practice there. So you have to go and sit for their exams . Who will pay for your expenses there- only you can answer.
10. Assuming the Government takes in a certain number to be absorbed as permanent doctors. Who will it choose? JPA scholars? Locally qualified doctors? MARA scholars? A certain ethnic group? If all these, then what happens those who were self financed or outside the ethnic group?Doomsday awaiting them?
1) yes
2) 6-12 months depending where you choose to do your HO
3) Yes and extension is also about 30%
4) Maximum duration to complete HO is 3 years. Total Contract year is 5 years
4a) Yes
5) Yup
6) Yes
7) The letter will come 3 months before your 1st contract ends.Yes, you may be transferred again
8) The letter will inform you whether you are receiving a permanent post or contract post. Backdated pay of U44 is only for those who received permanent post (backdated to the day they receive full registration)
9) Yes, unless your degree is recognised by the medical council of the country you intend to practise
10) No, JPA scholars are not guaranteed either. Our government was and will never be transparent.
Point no. 10 lol
Aiyo number 10. Lol answer easy. If Malay and Muslim confirm get permanent post. If you’re not this demographic they give you sisa sisa yang tertinggal. Like everything in Malaysia! Malay Muslim first. Everyone else last!
Not really, there are many Malays who also did not get permanent post. I also know many non-malay who got permanent post. However, I do not have the percentage at the moment.
For those who got permanent posts, please take note that this government is notorious for being a U-turn government.
I think nobody will disagree with me.
Once you are in permanent post, no U turn is possible unless disciplinary action is taken. Furthermore, these issue is nothing to do with the current government.
Easy. Just implement an entry exam for housemenship. The it should cut out 50% of the incompetent medical graduates.
A common entry exam was proposed in 2012, shot down by cabinet.
Common entry is a good suggestion. But if all must sit , then some locally qualified graduates may fail. Then they will say local public universities are no good. Also if local private University students cannot pass the entrance exam, problems again may arise regarding their reputation. That can affect their future intake of medical students. Also certain races may do well while other races may work hard to pass. Then how to answer the public then?
It’s called politics!
Common entrance examination….
our life is in the hands of the doctor. so if any medical graduates who are just half baked, the must go. unless you dont mind.
yes, agreed but we must have a transparent system to decide on this. There is NO standardised system to weed out the incompetent ones at the moment. Bias is rather common.
https://codeblue.galencentre.org/2019/09/09/only-15pc-of-malaysias-housemen-finish-training-within-two-years/
read this, how incompetent are the new medical grads
we all know this and that is the reason we proposed a common entry and exit exam which the government rejected. At the moment, there is NO standardised system to do this.
Most of the new medical grads study medicine because of parental pressure , peer pressure, for glory, money or a stable job. They will give up easily.
In the UK, to apply to study medicine most good medical schools will consider your:
1. extra curriculum activities. Having community spirit is an advantage hence, volunteering helps,
2. personal statements,
3. BMAT/UKCAT results, and
4. Interviews – getting straight As is no guarantee you will be accepted. Medical schools will also look into your personal qualities and reasons for choosing medicine hence, the importance of passing your interview. If you say you want to do medicine because you can earn tons of money you are bound to fail.
How many students with poor financial background end up doing medicine? Most are rich and those who get scholarships are also rich.What interview are you referring to? It is just eye wash.In fact , they will accept you if you tell them you want to make money. Why? Because they see that you are telling the truth and not ranting away some memorised passage from the Net on doing good for the community. Private Universities In Malaysia accept students and assist them in getting PTPTN loans. RM150,000. Balance you come out on your own. In the initial years, PTPTN used to give the RM150,00 0 in one lump sum. Parents placed this amount in FDs and earned interest on that while medical fees could be paid on semester basis. But now the loans are disbursed on semester basis but based on your semester results. If you fail in a semester, no loans for you for that semester. Now, visualise carefully. If there are 50 students in a class. 10 students fail in a semester. There will be no loans disbursed for that 10 students for that semester. Can the Private University allow this to happen? So what must the private University do to ensure money gets in every semester? Not overlooking the fact that some of the Private Universities are public listed entities and they have to show performance every quarter. So don`t blame only the student. The system itself is the culprit.
Then most IMU medical students come from rich families. They can afford to take UK , Australia partner medical programme in IMU.Hopefully they can do well and bring glory to Malaysia. I have one friend who has emerged as top student in Cambridge law school.
dude law and medicine lain tau
I was just wondering why compare medicine with law or for that matter any other subject? One can make as money as possible but at the end only the doctor can save your life.Even the most hopeless doctor will have some knowledge that ensures you can live for another day! Just remember two elements: You can qualify from UK, Australia, Malaysia, USA, Australia, India, Russia, Indonesia,Singapore , Egypt or even Poland. When you join HO and be in Government service, the salary for ALL medical graduates is the same. Two, at the end of the day, the question is whether you can deliver when it matters most.
The joint press statement by MMA indicates that only 20 % of the first cohort of contract houseman were given permanent post.
Is this really possible?
Out of about 1000+, about 500 got permanent post. But this 1000 includes 2 cohorts, the December and February cohorts. I am not sure how they came with the 20% figure. The percentage will get smaller as it goes.
Hopefully , most of them did not take a loan to study medicine in the first place.Otherwise, life could be very difficult for them.
Unfortunately majority of them would have taken PTPTN.
PTPTN is still OK. Who knows the next election pledge is to cancel all PTPTN debts?
The problem is what they are going to do if their contracts are not renewed.
They have to find their own jobs. That’s the norm in most countries.
https://www.thestar.com.my/news/nation/2019/11/17/a-glut-and-a-freeze-thats-waiting-to-explode#cxrecs_s
It looks like jobless doctors , dentists and pharmacists will increase in Malaysia in the future.
Malaysian parents, please always read The Star and Dr Paga’s blog.Stop pressuring your children to study medicine just to say to your neighbours, “My children are all medical doctors”. No government guarantees you a job.
yes, but trust me, they won’t listen! There will come a time when they have to say” All my children are doctors but most are jobless!”. Today’s paper reported that MOH is requesting for 10k post but read the fine print: these 10K includes all staffs! doctors, dentist, pharmacist, nurses, paramedics etc. I heard doctor’s post is around 1K+ only. Thus, nothing is going to change.
Very good, but hope only those competent ones are taken in.
All this problem stems from the fact that we have too many medical colleges with lax entry requirements and inadequate clinical training. These medical schools then churn out half-baked graduates without sufficient hospitals to take them for post graduation practice and experience.
I still think many here do not see the severity of the problem. What will happen to housemen who are not able to be absorbed into permanent post? Which private hospital wants to employ them? Can all the housemen go overseas? They will still need to sit for qualifying exams which ever country they are going.All the private colleges here would have applied for PTPTN loans for their medical students. Easy money coming.Just 1% interest . Rm150,000 maximum loan for medical programs. Repayment comes to roughly RM500 per month for 20 years.No government will cancel the loans, don`t worry. They can keep dreaming.
How to reduce the intake of medical students in private universities? All have political links. Take only one example. International Medical University(IMU)and International Medical College(IMC) are under IHH Healthcare Berhad ( which owns Pantai Hospitals and Gleneagles Hospitals), a public listed company.The education segment (IMU and IMC) generated RM257 million in revenue and RM84.9 million profits in 2018.The Non Executive Chairman is Dato Mohd Azlan. IHH Healthcare Berhad is owned by Khazanah Nasional at 42.3%. Fees per students is between RM500,000 to RM1 million. IMU will have its own hospital ready in 2021. ( all information pertaining to IHH Berhad is available on Bursa Malaysia website). So , who wants to reduce the medical students intake? The Health Minister? Heh! I am only here for five years and next election I don`t even know if I can get a ticket to stand for election. Can you see the bigger picture now?
Summary until now (November 18 2019):
1. Medical graduates will be under contract system beginning December 2016.
2. The system is 2 + 1 +2 and 3 + 2.
3. Our population is 33 million. We have 34 medical schools( public and private).
Probably the highest in the world in relation to the population. 300 medical
programs from overseas recognised here.
4.In 2018, 4924 medical graduates were admitted as housemen.
5.50% of new doctors will NOT be absorbed into permanent post.
6. Only 500 out of 1,000 housemen who completed HO were absorbed into
Government service. 50 received extension. The Government said 20%got
absorbed – not certain how this percentage was derived.
7.Those who are absorbed into Government service will be given a contract for
two years. Not made permanent yet though. And you will STILL be under
contract with UD41 pay scale, same as the housemen at RM 2947 pay.
8. If you are on contract as an MO, you can be be on parallel pathway doing
specialisation sitting for exams. But passing the exams does not guarantee
your permanent absorption into Government service.
9. Finally, no established criteria as to how one will be accepted as an MO after
HO.
1) yes
2) It’s 3+2
3) The 34 medical schools have 43 medical programs as some of them have 2 intakes or another twinning programs .
4) Yes, hitting about 5K in 2019
5) it’s more like 70% , 50% was for the first cohort, it will get less from now onwards
6) the remaining 500 got extension of contract for 2 years under same grade as housemen
7) Grade same as HO but pay might be at higher “tangga gaji
8) Yes
9) Yes, Malaysia boleh
Would there be some sort of decision by the Cabinet ,taking into consideration that the situation is already quite serious, and would worsen for the future batches, at their end of their contract ?
They may approve some post but it will never be enough. We are producing just too many graduates. People just have to find their own jobs as any other profession.
Saw this article from Malaysia Chronicle:
https://www.malaysia-chronicle.com/?p=180021
He has also written in some mainstream newspapers. I don’t think he is a doctor and most of his facts are wrong and suggestions are not practical!
What are the odds of getting a permanent post in KKM? Especially in this situation.
What are the doctors who have finished their contract, are now doing? Any feedback on their situation? Locum practice may be possible or is that so?
at the moment, it is about 30% chance of getting into a permanent post. It may get worst later.
The first batch of contract doctors have not completed their contract yet. They are into their 3rd year of the total 5 years.
Once you get your full registration after completing housemanship, you are eligible to do locum.
The odds of getting a permanent post is 50% or less as time passes by. The criteria keeps changing and no one will tell you the criteria either.
The doctors who finished their four years contract – what do they now? No news yet. The Government said they can become employed in the private hospitals, get employed at medical colleges as lecturers or set up their own clinics. Will they be able to handle their private clinics given the competitive nature of the business?
Locum is possible. Some say it is RM40 an hour while I heard it was RM 25 an hour. Question is will you work for RM25 an hour? A barber gets RM12 for a 15 minute hair cut!
On migration, it is now more difficult to do so now . Which country do want to you go to? The various exams you need to sit and pass. Who will sponsor you till you pass the foreign exams?
Maybe our Dr Pagal may want to add his valuable thoughts here.
medical colleges don’t employ non-specialist as their lecturers.
Most locum pay about RM35/hour.
Hi Dr Paga,
So sad to see this situation now afflicting our medical graduates. Noted that you said the chances of getting into a permanent post will diminish over time. However, this would also mean there will be less doctors doing their specialization because they wouldn’t be able to join the Masters course in local unis.
This would actually exacerbate our shortage of specialists in Malaysia and would defeat the purpose of enhancing the quality of medical care via training more of our doctors to be specialists. What is your take on this doc? Looks like a double edged sword to me. Any advice on how to tackle this issue?
master’s course depends on vacancy and number of post. Even now, many can’t get into the Master’s program and have to wait for years.
Basically, our healthcare system is not prepared for the surge in medical graduates. Post graduate training is not like undergraduate training. It is full time working and part time studying.
If we start producing specialist like our undergraduate medical schools, we must pray for Malaysia!
Hi dr paga, just wanted to ask what are the implications for contract medical officers who do not complete their 2 year compulsory service?
you will not get an APC to practise as a doctor.
What are the conditions for an Indian Masters holder tin the medical field to be accepted as a specialist in Malaysia ?
I was initially informed that if the first degree MBBS is recognised then the postgraduate would be accepted with the condition that the doctor has 10 years experience in that field..
Is this information correct.? Please advise accordingly.
The condition changes all the time. Yes, previously that was the rule. With the specialist register coming into force legally since 2017, it is MMC who will decide whether you can be recognised as a specialist or not.However, you must understand that public sector has stopped recruiting foreign doctors since 2014. Private sector generally do not employ foreigners unless they can prove to the government that they can’t find a local specialist. This rarely happens.
Does this new development also applies to a Malaysian who has a first degree from a recognised University and a MD/Masters from the same University ? The 10 year rule will no longer apply,I assume.
It all depends on MMC/NSR. Generally Master’s degree from India is not recognised here. However, it use to be 5 years of experience after Master’s about 20 years ago. But you must understand that you can only work in MOH hospitals to be recognised as such. Very rarely they allow you to go private directly even if you are a Malaysian.
Thanks for taking your time to reply on this matter
Hi Doctor. Lot of parents have been asking me the same question for the past three weeks. Hope you could throw some light on this.
A doctor completes the contract of 4 years. He /She does NOT get absorbed into the service. Assuming the doctor completes the housemanship and works as a floating MO for two years. What can this doctor do now?Parents have no money left to send the doctor overseas to further the studies. Can the doctor find a job in a local private hospital? Will they employ the doctor with a basic degree?
Can the doctor open a clinic assuming more loans are taken? What are the chances of getting some income from the clinic given the many community clinics in strategic places? Will the Government permit the opening of clinics anywhere or they will tell you in which towns you can operate?
Finally, if the above both cannot work, what can the doctor do after 4 years of working with the Government? Could not do any specialisation because the mental torture and stress during HO was too much.
On another note: Our members/readers here must STOP suggesting on restricting the number of medical students intake by private universities. This will never happen. All the private universities are politically linked and they are least concerned if graduates can find a job or not. One example IMU. This is under IHH , which is under Khazanah. How to restrict the student intake? Another example is MSU University. This is under former Education Minister Effendi Norwawi ( Tiara Jacquline` s husband), from Sarawak. MSU has now started a private hospital in their University in Shah Alam campus. Nothing will change at the ground level. What about introducing an entrance exam or qualifying exam? You want to kill the income of the politicians, is it?
Once you have completed compulsory service, you are free to do private practice. You can work as an MO in private hospitals, as a locum, permanent GP in private clinics, can open your own GP clinic or venture into other medical related fields. As a GP you can still do postgraduate studies such as Diploma in Family Med. and progress on to Masters in Fam Med organised by the Academy of Family Physicians, You can also sit for the FRACGP conjointly with the above. the MRCGP is another parallel pathway available now.
Beside these there are Occupational health, post grad. diploma in primary care dermatology, diabetes management, aesthetic medicine, palliative care etc certificates to acquire while working as a GP.
you can also do LLB external if you are interested in medico-legal issues .
As a GP, specialist recognition is of secondary importance only. What is important is personal development and life fulfillment.
The GP pathway would be a good proposal . However there would too many doctors applying for the limited MO jobs in the private hospitals. Would there be any statistics that show the number of applicants versus the number of posts at private hospitals?
I see vacancies advertised in the internet daily. Towards end of 2020, I think it would be difficult to get a job as an MO in a private hospital .
Yup as each hospital will only need about 4-6 full time MOs to manage their emergency department.
So to become a GP is the only realistic option for the majority. Good luck to all
As I said, the market will be flooded with GPs.
Private hospitals only employ MOs to manage their emergency department. Usually each hospital only needs about 4-6 MOs.
Thank you very much Doctor for taking great time and effort in educating and updating all of us. People just have to read all the messages in this blog twice and they will see a clear picture for the medical graduates.
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Great content sir. So by right, in order to complete the 4 year-compulsory service. In the 3rd year, anyone who has completed his/her 2 year-HOship and do not apply for permanent post, will automatically be given anther 1 year-contract, ya?
At the moment all will be given a total of 5 year contract. The first contract will be 3 years followed by another 2 years.
There is a proposal to reduce housemanship period from 24 months to 18 months. Is this confirmed?
MMC have to make this decision. Not MOH.
just wondering, the fate of graduate entry in medicine in Malaysia also the same right ?
Had always wanted to do medicine back then but was too poor , recently looked up and saw your blog , find out about the duke-nus md programme but it seems too hard to get in ….
any advice for graduate entry outside Malaysia ?
all graduates are treated the same, does not matter whether you are an undergraduate or graduate entry.
If you do not have financial difficulties, why not select IMU?
I do have financial difficulties..haha….imu got graduate entry?
Guess maybe I will not pursue medicine ?
To BBS,
If you have read all the above, there is strong advice not to pursue medicine as a career. I am not certain how determined you are, but the information and comments given above would suffice in helping you to decide. As our Doctor had said, whether you do locally or overseas( Indonesia, India, Bangladesh, Egypt, Jordan, Australia or even UK), you still have to go through the same procedures like all other medical graduates. Your salary, if working with the Government ,is the same for all.
By the way, you said you have financial difficulties. Medicine is an expensive programme. If you are looking for scholarships, then only Government Universities can provide that. Criteria is tough. Private Universities can only provide PTPTN loans. The amount given too depends if your parents are under BR1M or BSH.
The maximum amount under PTPTN given for medicine is RM150,000. A medical student who avails this will be happy initially. Once you start working on a contract basis, the repayment starts 6 months later. For the next 20 years, you need to pay back RM500 a month. Assuming, your basic salary as a HO is RM2780. First, you will buy is a small car. You need to put aside RM1,000 a month. Monthly installment , petrol , maintenance and parking charges. Minus the PTPTN repayment of RM500. Balance is RM1280.
You can visualise what this amount can do for you. You may get other allowances plus on call money. But those are not permanent. House rent, EPF, income tax, spouse maintenance(?), family support subsidy, holiday travel, credit card, and what not not taken into account yet.
No one is discouraging you. Better to know the ground realities now before any decision is made.
Time to ponder.
Babablacksheep, study medicine only after you become rich. Duke NUS MD programme tuition fees are also high.
I completed my housemanship in Feb this year, without any extension and with good results for each posting. I worked as ‘floating’ MO at ED dept since then with U41 salary, despite huge workload (especially during covid peak phase). Rubbing salt into the wound, we didn’t even get covid allowance as Frontliner just because we are still at U41 grade (most absurd thing I ever heard in my life). I’m happy doctoring, it’s my passion. Somehow I do feel betrayed by my own country. We, u41 floating MO, still exposed to all kinds of biochemical hazard and have same burden as permanent MO, yet receive a lot less salary WITHOUT covid allowance. And since we work at Ed, we are not eligible for oncall allowance as well. What surprise me was some of higher up (like sister, matron) get covid allowance even though they were not directly in contact with patients. Haha, such a dirty Malaysia politics in our healthcare system. I came home 3 years ago to serve our country but right now I feel betrayed by my own country. I should have stayed and served other country, I should have forgot all nasionalism value or sayangku Malaysia that has been instilled in school. Cause apparently my own country betrayed me. Truly a comedy from our own Malaysia politicians.
Which country you served before you came back to Malaysia? The UK?
Life is never easy. Each country have their own problems. But i feel all frontliners should be paid the covid allowance as long as you have been involved in the process. I thought that was what the minister said.
Hi Contract MO,
You have completed your HO without any extension. That is good. You are now a Contract Mo but still under UD41 scale. That is good but only temporary because they will upgrade you when the time comes. You have the passion for doctoring. That is good too. You are in the ED department but you are unhappy that you are not entitled to the special allowance .But you were told beforehand there will be no additional allowance for those in this department. Matrons and sisters are getting it . They are possibly in other critical departments. In many cases without them doctors cannot do their job.They are so good they are able to lighten the burden of the doctors. This is true in the top Government hospitals. They too have their own set of challenges but they are providing the best assistance to the doctors.
Let me tell you. Once the matron or nurse knows you are a good doctor, they will do their best to assist. But if you are under the X list, they will watch you closely. That is why as a doctor you must exhibit your positive attitude. In any department if you are blacklisted, it will be carried forward to other departments.
Which country do you want to go? Which country is welcoming you? Even though we talk about discrimination here, there are doctors who keep climbing because they are just good in their job. There are Chinese and Indians still holding top positions in Government Hospitals. They could have left for the private sector but they decided to stay. If your time is good all will fall in place. Life is so exciting that you will get it when you least expect it.
Stay positive and think positive. Because, if you are unhappy in your workplace, it will affect your work and your own attitude. A miserable life is what you will create. This unhappiness will be taken upon others. Sit down and think what options you have. The faster you get out of this unhappiness scenario, the better it will be for you.
Hi Dr Pagalavan. I am a born and bred Malaysian studying final year med in the UK. I am undecided whether to go back to Malaysia after my FYs, but I sincerely would like to head home as I miss my family dearly. Seeing as the current situation in Malaysia for medical graduates are horrific, what would you advise (knowing I truly would like to go home)? Kindly appreciate your time to reply.
Good morning to Dilemma,
While awaiting the professional advice from the good Dr, a small real life scenario.One of my cousins graduated from a UK University. Parents are wealthy but made sure the son obtained a Government scholarship. He tried for the first year but not successful and he got a dental program seat locally. After 1 year, his father told him to try again and he got the scholarship for the medical program in UK. Quit his dental program and flew off to the UK. Very happy. Came back and waited for 8 months. Got HO in KL. From the first day, non stop complaints. Hospital is hopeless. MOs are good for nothing. Always scolding him. Nurses not helpful at all. Parking is a big problem. No respect for him as a doctor. Salary is so low. I should have stayed in UK. How can I run away from all these ? How can I escape from paying back the Government if were to quit?
His life has been one of misery since he came back.I am not supporting him because he did not see the true picture. Now that the reality has sunk in, what can he do? Will his life be better in the UK? Are the MOs here so bad? Are the nurses here horrible? Without them where would he be? He is looking for a bed of roses – it does not exist anywhere.
Better think hard . Life anywhere could be the same or worse. It is basically what you want in your life. Your objective must be clear. Then only your strategy comes into place.
In life you have to make sacrifices. It is your future which is at stake and not your parents. I would suggest to complete your specialist training before coming home.