DETERMINANTS OF MEDICAL DOCTORS LEAVING MALAYSIA’S PUBLIC HEALTHCARE SECTOR: A NARRATIVE REVIEW

Abstract

The exodus of medical doctors from Malaysia’s public healthcare sector has become a pressing concern, with an average of 3.5 doctors resigning daily between 2019 and 2023. This narrative review explores the determinants of medical doctors leaving Malaysia’s public healthcare workforce, based upon literatures published from the past 2 decades. Literature search was conducted across five databases. From the 25 identified articles, five main themes were synthesized: “Career Advancement & Job Security”, “Professional Recognition & Work-Life Harmony”, “Workplace Culture, Environment & Support”, “Staff Welfare” and “Staff Emoluments”. Contributing key factors include limited opportunities for career progression, job insecurity among contract doctors, attractive private sector offers with significant salary disparities between public and private sectors, poor workplace conditions with heavy workload, inadequate emotional and psychological support. Additionally, bureaucratic inertia with lack of autonomy, and burden in balancing clinical and administrative responsibilities have strained medical professionals. In addressing these challenges to retain medical doctors in the public healthcare workforce, it is pertinent to improve career advancement opportunities, enhancing workplace support systems and culture while reducing workload, and also addressing salary disparities. Thusly ensuring the Malaysian public healthcare workforce being more resilient and sustainable, assuring provision of quality healthcare services to the population.