Losing our Life Savers: Why Malaysian Doctors are Saying Goodbye

Every year, Malaysia spends hundreds of thousands of ringgit training medical students, only to watch them cross the Causeway with little more than a nod of regret. Singapore welcomes them with open arms, competitive salaries, and career progression plans. We, on the other hand, offer them a lifetime of long shifts, stagnant contracts, and pay scales that rival those of clerical officers with a diploma.

In a nation where a clinic visit still costs just RM1, a policy proudly maintained since the 1980’s,  our healthcare system mimics that of a fragile illusion. Doctors are the scaffolding holding it all up. But that scaffolding is eroding, one resignation at a time.

Brain drain is not new to Malaysia. But when it comes to our medical frontliners, it’s more than an economic loss; it’s a quiet disintegration of national health resilience. The crisis isn’t that Singapore is poaching our doctors. The crisis is that we’re pushing them out.

And we’re doing it with policy decisions that value symbolism over sustainability.

What’s Driving Doctors Out?

Malaysia’s healthcare brain drain has become so normalised that few are shocked anymore. Just recently, Singapore’s Ministry of Health publicly advertised walk-in interviews for Malaysian GPs, to be held next month at Traders Hotel, Kuala Lumpur. The very fact that recruitment is happening openly, and on Malaysian soil, has sent ripples through the medical community and the public alike.

According to the Malaysian Medical Association (MMA), thousands of doctors have either left or are planning to leave the public healthcare system , with Singapore being one of the top destinations. The reasons are depressingly consistent: better pay, structured career paths, more conducive working conditions, and professional respect. Reported starting salaries are upwards of RM365,000 per annum, not including allowances for relocation and housing. The drain is not just affecting specialists, but junior medical officers too. 

What Does Malaysia Pay Its Doctors?

A junior doctor, or often referred to as a houseman in Malaysia,  earns roughly RM3,000–3,500 monthly. After five years of study ( at a minimum) , massive tuition fees, and passing notoriously tough exams, they are placed on contracts , and aren’t even offered permanent roles with job security. Many of them remain in limbo for years, contemplating their decisions in choosing medicine and whether they’ll be able to provide for their family. 

Meanwhile, entry-level government officers with significantly shorter training periods earn around the same or slightly less , but without overnight shifts, patient responsibility, or life-and-death decisions. This puts the average hourly rate for a houseman, not including the extra hours they may work due to staffing issues, at a mere RM15. 

In 2016, the government introduced the widely criticised contract doctor system to curb the rapid expansion of the public sector. It never achieved its intended goal and has instead gone on to create a class of burnt-out, undervalued professionals. These doctors not only face long hours due to lack of staff or systemic under-appreciation , but the toughest blow is that they do so without the guarantee of long-term employment. 

Not only that, pathways when it comes to promotion are often limited and subject to a variety of other existing systemic issues. Specialisation slots are limited, even locally. In other words, we are asking our doctors to sacrifice their youth, health, mental wellbeing, and everything in between, and we are not even offering them permanence in return.

An Unfair Bargain: RM1 for Healthcare, RM3,000 for a Doctor’s Soul

Few policies enjoy as much nostalgic pride in Malaysia as the RM1 fee for outpatient treatment at government clinics, which was introduced way back in 1982. It is often touted as a symbol of social equity,  proof that healthcare remains accessible to even the poorest citizens. It serves as a fall-back plan to politicians, if and when any of the new policies they introduce fail to accomplish its goals. What the policy makers fail to address is that behind the affordability lies a grim truth. This price tag is a financial illusion that the system, and its doctors, are quietly paying for.

The cost of treating a single outpatient is far higher than RM1. Medical supplies, medications, maintenance of equipment, and crucially, the salaries of medical staff, all add up. This token fee barely scratches the surface of the actual operating cost. While yes, we have to come to a consensus that this subsidy exists to bridge the gap in health equity, chronic federal underfunding means they rarely do. 

To the public , RM1 feels like a win. For doctors, it feels like being part of a system that undervalues not just their labour, but the entire health ecosystem.The RM1 price tag has another consequence, a political hot potato, that nobody in Wisma Putra dares to touch. Any suggestion of raising the fee is met with uproar. No party wants to touch it, for fear of appearing anti-poor and appearing in public to siding with the elites. Yet, if a serious conversation doesn’t arise in the next few months to a year on healthcare financing, doctors will be stuck in a loop, and we’ll  continue losing our talent to neighbouring countries. They are underpaid, overworked, and expected to maintain a subsidised system that refuses to evolve with the economic reality in status quo. 

In essence, the RM1 fee may be the most politically protected but economically regressive health policy in modern Malaysia. It preserves the illusion of access and helping the underprivileged, when in turn, all it does is drain the energy, resources, and the morale of the very people working to keep the system alive. 

A System Bound to Shatter

Malaysia’s public healthcare system has long been admired for doing more with less. But that same phrase of “stretching resources beyond reason” is now breaking the system from within.

With more doctors leaving or opting out of public service, hospitals face worsening shortages. Waiting times for surgeries, diagnostic scans, and even basic consultations have increased significantly. Cases have been reported where it’s not uncommon for patients to wait months for an MRI or spend over 10 hours in emergency departments before being attended to. 

This isn’t just an inconvenience,  it’s a public health hazard. 

In rural hospitals, the situation is far worse. Doctors assigned to remote areas often have to work without proper support, basic equipment, or even decent housing. Many end up leaving for the private sector, where the pay is significantly better. As a result, patients,  especially in underserved states like Kelantan and Sabah are forced to travel hundreds of kilometres just to get the care they need in city hospitals. The already fragile gap between urban and rural healthcare is growing wider, and at the heart of it all is a workforce that's slowly bleeding out.

Teaching hospitals are also feeling the pinch. Senior consultants are retiring or moving to private practice. Junior doctors are stretched far too thin, which means less time for mentorship, research, and surgical training. Malaysia risks not only losing doctors, but losing its ability to train the next generation of competent, confident medical professionals.

A system like this is not built to last. Not when the foundation, its people, are steadfastly walking away.

Not Just a Brain Drain: It’s a Respect Drain

Money isn’t the only reason Malaysia’s doctors are leaving. For many, it’s the chronic lack of respect, from the system and the public it serves. 

Young doctors describe toxic hierarchies within hospitals, where junior staff are often overburdened, micromanaged, and denied proper mentorship. Some work 24 to 36 hours without adequate rest, not because it's noble, but because it’s expected of a junior doctor. In many government hospitals, the phrase “kalau tak sanggup, berhenti” or “If you can’t, just quit” still echoes in the corridors, a cruel reminder that their exhaustion is seen as weakness, not systemic failure. In a viral thread on the Malaysian Medical Association - Section Concerning House Officers Facebook page; or the MMA Schomos, dated March 15th 2025, discussions went back and forth between junior doctors, HO’s and MO’s alike, with everything pointing towards the same outcome : your pay does not match your workload or the standard you’re held to; and the bare minimum of respect isn’t even credited to them by the system.

Are all senior doctors to blame for this? Not exactly, it’s  an issue that has been continuing since the dawn of the public healthcare sector, with the trauma being passed down from one generation to another.

Outside hospital walls, public perception adds another layer of pressure. The word “doctor” often conjures images of wealth and prestige, a far cry from the reality faced by most in the profession. Many are treated as typical civil servants, expected to accept their “secure” positions and serve the public without question. Efforts to advocate for better pay or improved working conditions are frequently met with accusations of greed or disloyalty. This was evident in 2021 during the nationwide “Hartal Doktor Kontrak” protest. While the movement drew significant national and international attention, it also triggered a wave of criticism and stern warnings from the government. What seemed to be lost in much of the chaos and backlash is a crucial fact: doctors are not just public servants , they are licensed professionals, trained to excellent standards, and deserving of fair treatment, not blind sacrifice.

"Hartal Doktor Kontrak" protest which garnered significant public attention in 2021, but was quickly shot down by the government

This lack of recognition builds over time. When paired with a system that offers no security, no clear advancement, and no space to grow,  respect becomes the least we as a country should be able to offer to our lifesavers.

Stop the Bleeding

Malaysia isn’t losing doctors because they lack patriotism; we’re losing them because the system makes staying untenable. We invest hundreds of thousands of ringgit to train each physician, only to leave them trapped in a cycle of temporary contracts, symbolic pay, and broken promises. The solution isn’t elusive ; it just requires the courage from a certain official to act.

So what needs to be done?

1. Abolish the contract system. The Malaysian Medical Association (MMA) has recently called for swift reform to the contract system. Restore permanent posts with transparent, merit‑based pathways, albeit with certain constitutional compromise, to specialisation and promotion.

2. Reform the RM1 outpatient fee. Maintain affordability for the poor, but introduce a tiered or means‑tested structure that reflects modern healthcare costs.

3. Raise federal health funding. It was a policy tabled in the Health White Paper (HWP) back in 2022 by the then Health Minister Khairy Jamaluddin. Malaysia currently allocates just around 2% of its GDP to healthcare , which is well below the WHO’s recommended 5%. The upcoming October budget tabling must reflect a serious shift, with a clear, substantial increase to support staffing, infrastructure, and rural services.

4. Reframe the narrative. We, the public, play an instrumental role in this. Doctors are not just public servants; they are professionals who uphold the very core of public wellbeing and deserve the utmost respect.
   

If we’re not willing to fund and fix the system, others will reap what we fail to value. Singapore already is. And when the last wave of doctors quietly walks away, it won’t be because they betrayed the country; it’ll be because the country betrayed them. 

By,

Mahessan Suresh,

Journalist,

Charisma Movement 2025

About Author

Despite the serious look in the photo (he swears he was just thinking about food), Mahessan is a Harry Potter nerd, sports addict, a student, and someone who loves digging into data to make sense of the world — all while doing increasingly random and chaotic things to stack up the lore.