On Malaysian doctors serving in overseas/海外大马医生回流的困境

If all Malaysian doctors serving in Singapore, Australia and the UK were to come back to Malaysia, we would not only at one fell swoop solve the problem of shortage of doctors, but may even have a surplus of specialists. Many options have been deliberated to attract these overseas doctors to come back but it all boils down to:

1) Money

2) Working conditions

3) Prospect of equitable career advancement

4) Social and political environment

The compulsory service in the government is a hindrance to doctors coming back. During my tenure as the minister, on a case by case basis, doctors did not have to serve the compulsory service if:

1) Their age > 40 years old;

2) On a case by case basis especially when there is an acute shortage of specialists in a particular subspecialty, for example oncologists, they may be exempted and;

3) Service in the army and university -->regarded as part of compulsory service. The 3 year compulsory service is not full time for doctors and specialists.

The problem now is that, if we waive the compulsory service for foreign doctors, local doctors will protest. Not only that, they will feel demoralised and discriminated against.

When the above rules were implemented, we managed to attract a mere handful of doctors to return. Nevertheless a major stumbling block was the lumbering bureaucracy known as the MMC secretariat -with regards to basic accreditation. A particular case which comes to mind(bearing in mind that it was only one of a few I had encountered during my tenure)was a Malaysian serving as a professor of surgery in a reknowned South Australian University Pediatric Unit. He applied to be registered with the MMC in order to teach medical students and surgeons in Malaysia. To my horror, he was given the merry go round with conditions that he had to show where he did his housemanship and posting which was done by this particular professor 35 years ago. He was also asked to complete his O&G rotation to qualify for a practising certificate. Fortunately common sense prevailed in the end after intervention. But the very fact that intervention from higher ups was even needed speaks volumes about the hurdles that many doctors coming back face.

In the government service, a lot of well intentioned policies are often frustrated by faceless beaurucrats who apply rules and regulations without using their common sense. Efforts to attract overseas doctors to come back with the current working climate is an uphill task. Until such a time as many fundamental issues can be be adressed, it will remain so.

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我认为，如果所有在新加坡、澳洲和英国工作的马来西亚医生愿意回流，不仅能一劳永逸解决我国医生短缺的问题，我们甚至有额外的专科医生。多年来，政府采取各项措施致力吸引国外的大马医生回国服务，而海外医生的考量可归结为:
1） 薪金
2） 工作环境
3） 合理的晋升机会和工作前景
4） 社会及政治环境

在政府医院实行的强制服务制是让海外医生不愿回流的阻力之一。我担任卫生部长期间，是以个案方式批审海外医生要求豁免强制服务的申请，若申请者符合以下条件，将获免除执行强制服务，或无需全职执行强制服务：

1） 年龄超过40岁
2）特殊原因以个案处理，尤其当申请者所属的次专科在我国正面对严缺医生如肿瘤科
3） 在军队和大学里服务医生

目前，政府面对的考验是，如果废除对海外医生实行强制服务制，本地的医生肯定群起抗议。不仅如此，他们会觉得被剥削而士气大跌。

话说回头，当时我们虽实施上述三项条件，惟只成功吸引少数的医生回流。 我发现，主要的绊脚石是对这些医生进行资格基准鉴定的大马医药理事会，在处理他们的申请时非常官僚。在我任部长期间，基本上不常出现类似的情况，但有一个案让我印象深刻：一位在南澳一间医院任职的大马儿科外科教授，曾向大马医药理事会申请注册，以允许他回国后在政府医院任教和指导在职的专科医生。让我震惊的是，程序其实很简单，但这位教授却被领着不断地兜圈子，包括必须出示他在35年前见习记录、期间被派任的记录和报告等。理事会甚至规定这位教授必须到妇产科轮值，以获取实践证书。最终，幸得部门高层介入而顺利解决该教授的问题。

事实上，我们需要有关当局的高层更全面地检视外国医生回流所面对的障碍。在公共服务领域，因为一些官老爷的愚昧和官僚，许多善意的政策被曲解，无法让人民受惠。如果政府机构内续存这种不良的文化，吸引外国专才包括医生回流的努力，恐怕依旧事倍功半。