PETALING JAYA: With fewer doctors taking up housemanship slots, it is up to the government of the day to decide if it still wants to continue with the contract system, says former health minister Tan Sri Dr S. Subramaniam (pic).
It could instead choose to offer permanent positions to medical school graduates, he said.
“If the government decides that, with today’s outflow from training schools, it has the capacity to give permanent posts to everyone who graduates, it should do so.
“However, if the government feels that the contract system affords a flexibility in increasing the number of posts according to the number of graduates, then it should be structured as such.
“It must not become an impediment for the graduates’ professional progress,” he said.
Dr Subramaniam told The Star that contracts had to be long enough for doctors to make adequate progress.
“I have proposed some time ago that contracts should be for at least for 10 years, which would give enough time (for a doctor) to finish their housemanship, (stint as) medical officers (MO), go into a training programme and then probably become a specialist.”
Health Minister Datuk Seri Dr Dzulkefly Ahmad recently revealed in the Dewan Negara that when the ministry opened up 5,000 slots for housemanship in January, only 529 were filled, a development seen as worsening the manpower problem in public healthcare.
This year marks the 10th year since the implementation of the contract system, which began when Dr Subramaniam was health minister.
Housemen now serve for two years, and can get contracts as MOs for three years, which may be extended up to maximum of seven years.
“If you don’t give a long enough contract, you are denying doctors professional progress,” Dr Subramaniam said.
On Dzulkefly’s statement that only 529 took up the housemanship slots, Dr Subramaniam expressed surprise.
“With about 4,000 medical graduates, it is important to find out why thousands decided to not take up housemanship.”
There are currently enough medical schools, including private ones, to train about 4,500 to 4,800 doctors per year.
To practise in Malaysia, one needs to be registered with the Malaysian Medical Council (MMC), which requires housemanship training under the Health Ministry.
“The challenge we faced earlier, for example from 2014 to 2018, was that the number of graduates coming from our medical schools increased substantially.
“We had about 4,600-plus doctors graduating in 2014, 5,050 in 2015, 5,240 in 2016 and 6,114 in 2017,” he said.
However, he said, there were only places for about 3,000 to 4,000 housemen.
“Consequently, many had to wait a minimum of six months (for housemanship).
“Some even waited a year and a half before they could be absorbed,” Dr Subramaniam added.
The Public Service Department (JPA) was asked to increase the number of housemanship slots, which were permanent positions at that time.
“Looking at the long-term financial implications for the country, JPA was not in a position to increase the number of houseman posts in tandem with the number of graduates,” Dr Subramaniam said.
It was against this background that the contract system was introduced.
It cut waiting time and fulfilled the government’s obligation to ensure adequate training opportunities for all housemen. However, the way this contract system was managed has led to many problems.
Public agencies, too, have cut down on their scholarship sponsorship of students to study medicine abroad.
