Concerned about the oversupply of doctors and housemen (junior doctors) in the country, the Malaysian government has recently imposed a five-year moratorium on medical courses.
According to the Malaysian Medical Council, Malaysia has 27,709 doctors (including 3,651 house officers). Malaysia is producing about 3,500-5000 medical graduates annually, a big figure for a country with a population of 27 million.
This is largely because of the sharp increase in the number of medical schools operating in the country. A few years ago, there were less than 10 schools offering medical programmes. Today, in contrast, there are 24 medical colleges: 10 public universities, 12 local private providers, and two foreign medical schools. Students are also allowed to study in about 50 accredited foreign universities.
The oversupply of doctors and housemen is obvious in the country’s 39 training hospitals, while in many urban hospitals, there are actually more doctors than patients.
The government hopes that the moratorium on medical courses will help Malaysia achieve a doctor to patient ratio of 1:400 by 2020, which is considered the benchmark for a developed nation. Doing so will be crucial if Malaysia is to its achieve goal of being a major medical hub in the region in the next decade.
But reducing the number of medical graduates is also a policy reform aimed at improving the quality of health care service within the country. After all, it has been noted by health authorities—and the general public—that the quality of new doctors has gradually been decreasing over the years. Hospital officials are complaining that the new batches of housemen, especially graduates from foreign schools, seem to be poorly trained.
There’s no question about the need to improve the quality of doctors, but is the moratorium an appropriate policy tool? Perhaps the government should also review the license granted to local and foreign schools in recent years—many of these institutions are churning out half-baked and underperforming graduates.
The government should also consider other proposals from the medical community. For example, senior health specialists are pushing for amendment of the Medical Act of 1971 to make the Medical Qualifying Examination compulsory for all students. The examination is only given to students from non-accredited foreign medical schools.
And it’s also necessary to probe the continuing brain drain of doctors in public hospitals. Despite the overcrowding of doctors in most private hospitals, several public hospitals are suffering from a shortage of qualified medical personnel. The government should therefore try to convince doctors to remain in government service.
Malaysia’s bold decision to introduce a moratorium on medical education (it also imposed a moratorium on nursing education in 2006) should inspire other countries in the region, most notably the Philippines, to review their medical education programmes. Malaysian educators proposed the moratorium precisely to avoid the mistake of the Philippines which is mass-producing doctors and nurses even if when the domestic demand couldn’t absorb the new graduates.