Doctors are overworked, underpaid: How we’re failing our most critical workers

It takes a minimum of four years to complete medical school. Three years of compulsory clinical training — or the housemanship period, as it’s usually referred to — usually follows. Then there’s the extra four or so years for specialist training, with another three added on for sub-specialist instruction. 

In total, experts estimate that doctors spend at least 18 years and more than five million Malaysian ringgit (approximately US$1,134,147.50) in their medical training. Despite this, there has been a wave of doctors on strike in Malaysia. 

In the eyes of the majority of young medical graduates, it’s a movement that has been years in the making. Some 8,000 out of 20,000 contract medical officers are expected to participate in the strike arranged by Mogok Doktor Malaysia (Malay for “Malaysian Doctors on Strike”), using up their annual or emergency leave days to do so. 

Around 3,000 contract doctors may be resigning this month, too. Poor working conditions and minimal pay are the driving factors behind this. 

“For me, it is quite challenging as most days we have to work continuously and we don’t even have enough rest,” a doctor was quoted saying to a Malaysian newspaper, the New Straits Times. “There are times when our break time is not even 30 minutes long. Not only is the workload heavy, but we are being paid pennies.”

Malaysian doctors on strike have been lobbying for better conditions for years. In 2021, healthcare workers were pushed to the brink due to a surge of COVID-19 cases.

The increasing number of cases and deaths prompted overworked doctors to announce a strike. Other protest movements such as wearing black to work have also been arranged by Malaysian healthcare workers. 

What, then, is the value of graduating with a medical degree?

Contract doctors previously staged a walkout in 2021 amidst a worsening coronavirus outbreak. Source: Arif Kartono/AFP

Doctors on strike in Malaysia: a rundown

The Malaysian government spends more than one million ringgit over the course of five years to produce one doctor. Despite this, it is facing a nationwide public health crisis — one that is driving its professionals to look for opportunities elsewhere. 

Much of this has to do with Malaysia’s contract-based system. Most doctors starting out are employed on a contract basis, from three to five years. The drawback: the majority of doctors are not offered permanent posts once their contracts are up. 

Contract doctors in Malaysia are denied certain entitlements usually afforded to full-time permanent healthcare workers. This includes pension, as well as a significantly lower salary range of less thanRM 2,000 (around US$454) per month. 

As such, Malaysian doctors are choosing to migrate overseas for work. Many are turning to neighbouring country Singapore, as well as other options such as Australia and the Middle East. 

Spokespeople are urging the government for a complete reform of the healthcare system. 

“There are enough doctors in Malaysia but doctors for certain specialities are limited such as psychiatrists and physiotherapy, especially in the private sector,” said Association of Private Hospitals Malaysia (APHM) president Datuk Dr Kuljit Singh. 

“The real problem we are facing is lack of positions that are offered by the Health Ministry and lack of funding to train new specialists and most importantly unconducive working environment,” he added.

However, the recent change in government may lead to a more promising future.

Just one day following the recent Mogok Doktor strike, prime minister Anwar Ibrahim announced a move to absorb 12,800 contract doctors into permanent positions within the next three years. 

This is a result of an increase of three billion ringgit in emolument in this year’s national budget. 

Strikes by healthcare workers are not unique to Malaysia. Source: Paul Ellis / AFP

We should be paying closer attention to the healthcare field

The struggle faced by doctors on strike in Malaysia is not unique to the country. Junior doctors in the UK went on a three-day strike in March after their pay fell by 26% since 2008. New Zealand doctors on strike similarly demanded better working conditions and wages in 2019. Last month, nurses in Toronto, Canada marched for better wages, staffing and working conditions. 

It’s clear that the medical field is facing a global crisis — that of undervaluing its workers. The COVID-19 crisis showed with glaring clarity how doctors were facing burnout, unsanitary working conditions and critically low pay. 

Why, however, is this the case? It’s no secret that healthcare workers are among the most necessary of global professions. Students spend hundreds of thousands of dollars on a medical degree in pursuit of this noble profession. Even those pursuing medicine in “cheaper countries“ fork out a significant amount of money to pay for their education. 

Medical students are hardworking, committed and willing to sacrifice their own health and well-being for others. Yet the structures they are working relentlessly to uphold are failing them. 

Governments need to address this — and quickly. Medical students are already moving away from the field. The World Economic Forum predicts that there will be a shortfall of 10 million healthcare workers by 2030. These will primarily be in low- and middle-income countries, where such services are needed the most. 

If there is any profession worth investing more into, it’s the healthcare field. After all — how will we possibly cope without the support of healthcare workers?