Page 15 - MOH Supply and Needs-Based Requirement Hyperlink 02032021

7 EXTENDED EXECUTIVE SUMMARY

1.2 Training, Role and Key Facts of Human Resource for Health

1.2.1 Doctor

Doctors, as defined in this study, are fully registered medical practitioners with the Malaysian
Medical Council (MMC), i.e. medical officers and medical specialists. The career pathway
of doctors begins with a minimum of five (5) years of undergraduate training, which is
offered by the medical faculty in universities locally and abroad. In 2015, there are ten public
universities and 20 private universities that offer medical courses in Malaysia. In Malaysia,
medical graduates need to undergo a minimum of two (2) years clinical training period
known as housemanship before obtaining the full registration with MMC. This clinical
training period is to ensure their competency as medical practitioners.

Although there can be other ways to categorise doctor services, i.e. by discipline, speciality
training, facility type, this study categorised doctors’ services into direct and indirect
patient care. Direct patient care is defined as health care services encompassing the entire
spectrum of care provided directly to individuals or patients, ranging from preventive care,
and primary to tertiary care. On the other hand, doctors engaged in indirect care are those
involved in public health, administration, academic, research and regulatory. They do not
provide patient care directly to individuals. Doctors working in the public sector usually
work as a team of doctors and support staffs within a specific discipline. A team of doctors
especially in government hospital setting may consist of a consultant, specialist, medical
officer and house officer (HO). A patient requiring multidisciplinary care will have more than
one team of doctors from various disciplines working together in providing medical care. In
a department or facility without a specialist, medical officers handle cases with the back-up
of a specialist through the referral system.

Over the past ten years, Malaysia has seen a marked increase in the number of doctors
which resulted in improvement in doctor to population ratio. Concurrently, plenty of news
on issues related to new medical graduates awaiting housemanship training, which is often
interpreted as a lack of employment opportunity in Malaysia, is reported in mainstream news
and social media. Meanwhile, new public and private health facilities continue to flourish
while existing healthcare facilities offer new services, which need doctors. These mismatched
scenarios cause misperception among the clients as they continue to experience long
waiting time for medical care while healthcare managers are facing challenges to work
within their means, with inadequate supplies of doctors, to maintain the safety and quality
of medical care services. Hence this study was conducted to shed some light on the future
status of doctor supply concerning the needs and demand for their services. The results on
projections of supply and requirement for doctors were based on initial data of the doctor
population as of 2015 summarized in Table 3.

SUPPLY AND NEEDS-BASED REQUIREMENT PROJECTIONS OF MALAYSIAN HUMAN
RESOURCES FOR HEALTH USING SYSTEM DYNAMICS APPROACH 2016 - 2030