Injustice Against Doctors in Specialty Training: Remove the Career Barrier

This manifesto, written by a doctor criticizing the 2026/2027 subspecialty admission process, emphasizes that the issue is not about lowering standards or attacking Parallel Pathway colleagues. The main focus is voicing a demand for justice, consistency, and accountability in public service. The manifesto addresses a structural problem that urgently needs a solution to ensure equality in educational and career pathways. In this context, the barriers faced by public servant doctors trying to transition to post-specialty training are examined in detail. At the root of the problem lies the public administration issuing contradictory instructions at different times and punishing candidates due to these inconsistencies.

It is reported that doctors applying for subspecialty training receive contradictory instructions at different stages regarding the required annual performance appraisal report (LNPT). While some sources require three consecutive years of full appraisal, others state that the report from the year spent on study leave can be used. Another instruction suggests that reports containing a full twelve months of appraisal from past years may be accepted, while subsequent briefings demand appraisal for only the last three years without specifying that they must be consecutive. The manifesto emphasizes that this is not merely a minor difference in wording, but a crucial issue that could cause a specialist's career to progress or be delayed for years. A system issuing changing instructions, allowing candidates to comply with them, and then rejecting them on the grounds that they failed to meet an interpretation that was never consistently communicated is defined not as good management, but as moving the goalposts after the race has begun.

The injustice in the situation of doctors who specialize through local Master's programs, in particular, becomes even more apparent. It is reminded that doctors on fully paid study leave (CBBP) do not cease their service, remain public servants, and undergo an accredited master's training. During this process, it is stated that they go through rigorous exams, fulfill clinical duties, undergo hospital rotations, train in national reference centers, conduct research, and are continuously evaluated throughout their programs. Despite this, although they are recognized as specialists upon completing their training, they are warned that the years spent in a structured, publicly supported training program are not considered sufficient for career advancement. The system implies that a four-year master's training is enough to make a doctor a specialist, but not enough to prove that the doctor actually performed. This is portrayed as not only illogical but also a demeaning approach.

The structural inequality created by this approach becomes clearer when compared to colleagues from the parallel specialization pathway known as the Parallel Pathway. A specialist from a defined specialization route can remain in the public service and accumulate three consecutive LNPT reports, even if they graduate later, allowing them to start subspecialty training earlier. On the other hand, a doctor who specializes earlier through a Master's degree, serves the same public system, and holds the same recognized specialist status is forced to wait for years because they cannot obtain three consecutive LNPT records due to the study leave structure. It is estimated that this creates a difference of up to four years in the completion of post-specialty training among doctors. It is emphasized that this difference does not stem from a lack of talent, negligence in service, or exam failures; it is solely due to the fact that the doctor entered a training structure created by the state itself, which it later refuses to adequately recognize.

It is reminded that Malayzya constantly needs more specialists and subspecialists, and that there is a shortage of personnel in neurology, cardiology, nephrology, anesthesiology, infectious diseases, oncology, psychiatry, surgery, and many other critical fields. Despite this, placing barriers before specialists who wish to receive further training is considered a highly unusual approach in terms of workforce strategy. The manifesto states that a series of steps must be taken to urgently resolve the current problem. All affected applications must be fairly re-evaluated based on the written instructions in effect at the time candidates applied. It is demanded that structured performance appraisals conducted during study leave, including exam results and institutional evaluations, be accepted as valid proof of performance for subspecialty applications, and that all application requirements be published transparently and applied for future applications. Finally, a call is made to the Ministry of Health and the Public Service Department to establish a transparent appeal mechanism containing written justifications for every rejection decision. These demands are defined not as a request for special treatment, but as the minimum standard of justice owed to doctors who fulfill their public duties, undergo training, pass exams, and protect the health of the Malayzyan people.