Public hospitals in Malaysia’s Bornean states of Sabah and Sarawak are facing significant challenges in attracting and retaining medical officers, with more than one-third of doctors offered permanent positions failing to report for duty. Despite online welcomes and recruitment efforts, healthcare facilities struggle to fill vacancies in the region, highlighting ongoing difficulties in staffing public hospitals.
Malaysian Health Minister Dzulkefly Ahmad disclosed on Thursday that out of 1,055 medical officers offered permanent appointments in East Malaysia, 382 had yet to report, indicating a 36 percent no-show rate. Although this represents an improvement from 42 percent in 2025, Dzulkefly acknowledged that the figure remains unsatisfactory.
Doctors cited family separation, uncertain career progression, and challenging working conditions as primary deterrents to relocating to the Bornean states. Many expressed concerns about the long-term viability of such appointments, even after initially accepting them.
One junior doctor, identified as Dr S, relocated from Kelantan to Sabah’s east coast in late September after securing a permanent role. Despite support from colleagues and specialists, she described the move as financially and emotionally taxing, noting out-of-pocket expenses of approximately 2,000 ringgit (around HK$3,800) related to upfront costs such as rent and basic necessities. Dr S also highlighted the heavy workload caused by staff shortages but said she expected to remain in the position for no longer than two years due to family considerations.
Conversely, Dr AN, another contract doctor, opted to decline a permanent appointment in Sarawak, preferring to stay in Kelantan to attend to her own health and care for an ill family member.
Minister Dzulkefly identified multiple factors contributing to the reluctance among doctors to accept or retain placements in Sabah and Sarawak. These include a preference for urban healthcare facilities, concerns about access to specialist training, and difficulties securing transfers back to their home states. In response, the ministry is exploring the implementation of a dedicated 30 percent quota for specialist training spots allocated to medical officers serving in East Malaysia, aiming to improve career development prospects in the region.
The challenges are further illustrated by the experience of Dr A. Iswaran, who served on contract postings in Sarawak and Sabah before seeking a permanent position in Sabah in 2021. After his request was not granted, he declined contract extensions and left the public system, citing inadequate staff housing and support. His case underscores infrastructure and retention issues faced by healthcare workers in these states.
To encourage retention, the health ministry has introduced measures such as earlier placement notifications and full transfer allowances to cover travel, meals, and lodging for eligible officers. However, concerns remain about staffing shortages. The Malaysian Medical Association (MMA) reported that several hospital departments in Sabah are experiencing a net decline in medical officers, forcing doctors to endure on-call shifts lasting between 24 and 33 hours every other day. MMA president Dr Sivanaesan Letchumanan warned that official placement figures may not fully reflect frontline staffing realities.
In a broader context, the Malaysian government’s 2027 budget, unveiled on Friday, includes commitments to offer permanent appointments to over 9,000 contract doctors nationwide in an effort to address nationwide healthcare workforce challenges. Whether these initiatives will improve recruitment and retention in East Malaysia remains under close observation.