“Why Are We Paid Less but Asked to Do So Much More?”

Humans of Medicine #20

This publication is in conjunction with MMI’s National Contract Doctors Day Celebration. Information regarding the project can be found at @mmi_social on Instagram. 

When I was a final year medical student, I gave in to peer pressure and applied for an internship in Australia. I did it half-heartedly, thinking that I wanted to stay in Malaysia and serve the people here.  I continued with housemanship, which was relatively bearable, but my commencement as a contract medical officer (MO) made me realise that I had to do something to safeguard my job security. 

For context, contract MOs are medical professionals with the grade UD41 (which is the same as house officers) after they complete their housemanship. This position came into play after the introduction of the contract system in December 2016. We are given a 3 year contract with a 2-year extension, therefore 2 years as a house officer and the rest as a contract MO. Previously, after house officers complete their 2-year compulsory service, they will be absorbed into the healthcare system as permanent medical officers. This confers them the grade UD44 - meaning a much higher salary, study leaves, hazard leaves and the eligibility to enrol in a Masters program. As of right now, some of us will be absorbed to become permanent MOs, but there are many questions as to what will happen regarding those who will not. 

I was a contract MO in the Emergency Department in a Malaysian public hospital. The situation was the worst when the COVID-19 pandemic first hit us. Cladded in layers of personal protective equipment (PPE) for at least 10 hours while managing patients, I could not eat or go to the toilet; PPE denied us these basic necessities. Sweat gathered uncomfortably under my PPE despite the air-conditioned settings of the hospital. 

As contract MOs, we are expected to perform at the same level and carry out the same tasks of a permanent medical officer. We are called to manage suspected cases of COVID-19 and curate a plan for all the patients that come in. We basically take on the same responsibilities as our permanent colleagues. Yet why are we paid less – the same as the housemen whom we supervise – while doing so much more? Why do we have to compromise our welfare for the pitfalls in the system? 

We are bettering our work to serve the country. We have been training to become professionals, to serve the nation and to give it our all. Our skills are worth so much more.  Yet it feels like we are being penalised, like we are becoming the sacrificial lambs when the healthcare system cannot sustain itself. 

To put it simply, the government has been trying to plug holes with temporary measures without thinking of the long-term consequences. Us junior healthcare professionals are stuck paying the price.  For instance, Malaysia only recognises local Masters programs for surgical specialities, but contract officers are unable to apply. Going overseas to do a surgical specialisation isn’t an option.  As such, any contract MO who intends to do surgery will be stuck in a waiting limbo. Malaysia may soon see a decline of specialists and a reduction of doctors as we leave to seek better prospects elsewhere. 

I am frustrated and disappointed with how the government has treated us. I never thought of leaving the country; I have always wanted to serve my nation and its people. But the system has failed me, and I am now ready to seek a better future in Australia. A part of me hopes that my departure will help in the fight for better treatment of contract doctors.

To my senior colleagues, please fight for us. Stop saying that it is just a small difference and we should be grateful. Would you want to be put in our positions?

To my fellow contract doctors and juniors, do not ever stop standing up for your welfare. Make sure you have backup plans for later because let us face it - the system isn’t on our side right now. 

To the government, please rectify this and safeguard the welfare of contract medical officers. What happens once brain drain becomes too big to ignore and the country loses more young talents?

Goodbye Malaysia. One day I hope to return, but until then, something needs to be changed.

About the author

Interviewed and written by Dr Ong Siu Ching. She is the Co-Chair for Malaysia Medics International for the term 2020/2021.

Consent has been obtained from the interviewee for the purpose of this publication. The author has rewritten the article with permission from the interviewee.

Humans of Medicine is a new initiative under MMI. We tell inspiring stories behind portrait shots of our everyday unsung heroes. Curated by Malaysian medical students from home and abroad.

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