To keep talent, reform Malaysia’s healthcare from the inside

Overproduction of healthcare graduates has led to a glut in some areas, while rural regions face severe shortages 


STARTING a career in healthcare is akin to moving from the security of a classroom to a trial by fire. 

Amirul Adli, 27, said nothing prepares a medical student for what is about to come in real practice. 

With little training for high-pressure workflows, new healthcare workers like Amirul would often feel like they are being “slammed straight into a wall”. 

Having studied in Shah Alam and now doing his housemanship in Kota Kinabalu, Amirul is burdened by student loans and is being paid too low for today’s cost of living. 

He said while committed mentors can guide novices through the demanding learning curve, systemic improvements are imperative to support Malaysia’s healthcare heroes. 

“With better workplace cultures and training aligned with real-world rigours, my generation would thrive in service of patients. 

“But for now, most see brighter prospects abroad. It is too tiring here,” he told The Malaysian Reserve (TMR). 

Worried that the conditions would extinguish his passion, Amirul said unless Malaysia nurtures new clinicians, it risks losing them. 

Initially interested in specialising in a specific segment, he has changed his mind due to time and energy constraints. 

“I do not want to spend so much time specialising. By the time I’m done with the training, I would already be too old with not so much energy. 

“What I really want is better pay, reasonable hours, pensions and improved facilities,” he said, explaining his change of heart to general practice. 

Budget priorities focus more on infrastructure over staffing needs, says Dr Mior

Shortages of Nurses and Doctors 

Malaysia is experiencing shortages of key healthcare personnel, especially nurses and doctors. 

Dr Mior Mohd Yusof Adnan from the Association of Malaysian Islamic Doctors (Perdim) said the biggest problem or challenge faced is not in training them because this country has many institutions and training centres in universities and private and public colleges. 

Rather, Malaysia faces difficulties in workforce planning and placement. Overproduction of healthcare graduates has led to a glut in some areas, while rural regions face severe shortages. 

“There is no dumping of skilled and professional personnel like doctors and nurses in the market as a result of planning weaknesses during the student recruitment process and their placement after graduation. 

“The government also faces problems in financing public healthcare workers’ salaries due to the lack of financial allocations in the annual budget to the Health Ministry (MoH),” TMR was told. 

He pointed out that budget priorities focus more on infrastructure over staffing needs. 

While Malaysia has no shortage of medical and nursing schools, more can be done to expand access. 

Dr Mior noted that the Covid-19 pandemic had significantly reduced enrolments, especially in nursing colleges.
“Many nursing colleges froze or reduced 
recruitment,” he said.

He believed that increasing enrolments back to pre-pandemic levels will remedy the temporary nurse shortage. 

Long Hours and Poor Conditions 

Punishing work hours and outdated facilities also push healthcare workers out of the public system. 

Commonwealth Medical Association president Dr Muruga Raj Rajathurai said housemen and junior doctors are made to work long hours, most of the time coming into work two to three hours earlier, and leaving two to three hours after their shifts were over. 

He noted that junior doctors often work far more than the 48 hours per week as recommended by the World Health Organisation (WHO). 

To curb excessive hours, Dr Muruga suggested enforcing clock-in and out policies. “One idea is to make sure that they work their shifts and leave with a proper pass-over to the next shift so that the patient’s care is not compromised.

“This way they will have a better work-life balance, less burnout and eventually better performance at work,” he told TMR. 

He also stressed on poor remuneration. 

“The government must find ways to review and give the long-overdue increment or risk losing public healthcare workers to the private sector or overseas.” he said. 

Dr Muruga agrees that there is a toxic work culture in public hospitals and clinics that drives staff away

Retaining and Attracting New Talent

Brain drain has long plagued Malaysia’s healthcare system, with many professionals leaving for opportunities abroad. 

Dr Mior emphasised that the need for better workplace culture and training opportunities to keep talents in the country. 

“A more conducive work environment includes a work culture that helps each other and reduces bullying among seniors. 

“Opportunities for advanced training must also be increased in terms of financial allocations and places to be filled,” he said. 

Dr Mior added that healthcare organisations should appreciate and recognise the skills and experience of senior staff, especially those who have served in the hinterlands of Malaysia. 

“Ideally, senior doctors and nurses should be given more attractive salaries, promotion opportunities and various incentives,” he said. 

Public perception and outdated career views are also deterring many from pursuing careers in the healthcare sector. 

To address this, Dr Mior encouraged showcasing the diversity of healthcare roles. 

“The public needs to see healthcare as a wider and more interesting career field, not as what our forefathers used to practise,” he said, highlighting new opportunities like telemedicine, house calls for elderly patients, and travel medicine. 

He noted that a career as a companion doctor for a tour group or umrah has yet to be fully explored. 

Dr Muruga also acknowledged that the country is moving towards telehealth or telemedicine, pushed by the pandemic. 

“Patients have become comfortable getting consultation from the comfort of their home. “They do not want to look for a car park and wait in long queues. This way they are also not exposed to pathogens in the clinics,” he said, adding that accelerating the growth of telehealth would modernise and streamline patient care.

Moreover, Dr Mior advocated for expanded public-private partnerships to strengthen on-the-job training programmes. 

With a mix of public hospitals and private clinics and hospitals, Malaysia’s healthcare landscape is diverse, hence, a better collaboration is essential for the wellbeing of all people. 

Dr Muruga agreed that Malaysia’s primary workforce challenge is a debilitating brain drain driven by dysfunctional public sector work culture. 

“Thus, the crux of Malaysia’s healthcare woes may be less about training capacity than about retaining and fully utilising the qualified personnel it has already produced,” he told TMR.

He admitted that there is a toxic work culture in public hospitals and clinics that drives staff away. 

This includes bullying of junior staff by seniors, lack of transparency in hiring and promotions, extremely long working hours, and poor workplace conditions. 

“People are willing to migrate to another country because of the toxic work culture that is practised in our public hospitals. 

“If the Malaysian government keeps denying this, then there is nothing much we can do to stop the loss of talents,” Dr Muruga said. 

He also called for reforms in the hiring process. 

“The Health Ministry has to find ways to give more scholarships and training opportunities for specialist training immediately or else the country will face a shortage of specialist doctors soon,” Dr Muruga added. 

Dr Muruga also acknowledges that the country is moving towards telehealth or telemedicine, pushed by the pandemic

Talents Flying Abroad 

Malaysia’s healthcare woes are compounded by wealthier neighbours luring away local talents. 

“Our neighbours are luring away our junior doctors. They headhunt our talents when they are still in their final year medical schools,” warned Dr Muruga. 

He argued this represents both a financial loss from subsidised training and a brain drain of top talent. 

“These doctors are taken from top public universities, so we lose taxpayers money as well as our top students,” he lamented. 

To stem the outflow, Dr Muruga suggested requiring the neighbouring countries to repay Malaysia’s educational investment before hiring graduates. 

Healthcare Heroes Are Made, Not Born

By implementing thoughtful policies that prioritise long-term workforce development, Malaysia can train the next generation of talented nurses, doctors, and specialists. 

The nation’s well-being depends on empowering and growing its healthcare workforce. 

  • This article first appeared in The Malaysian Reserve weekly print edition