Restricting civil-servant posts will not solve shortage of doctors, caution medical students

After the ministry announced its decision last week, medical students spoke up to say that this policy will prove ineffective in keeping new doctors on the rolls in public hospitals. Doctors working in rural areas have also called on the Public Health Ministry to review their policy on granting civil-servant status to doctors and ensure that medical staff have secure jobs and better working conditions if they are serious about solving the chronic lack of qualified physicians. 
Recent policy change includes restricting the number of civil-servant posts granted to newly graduated doctors from 2021 as well as calling on private hospitals to cover the education costs of some medical students. 
A Khon Kaen University medical student, who asked to be called “Prem”, said he would be part of the first batch of new doctors to be affected by the policy, as he will be graduating after 2021. Hence, he warned, if he and his fellow students are unable to obtain good welfare benefits and job security, then they will be forced to seek jobs in the private sector, which will worsen the shortage of doctors in public hospitals, he warned. 
“Since the OCSC [Office of the Civil Service Commission] disclosed this policy last week, me and many of my friends have been discussing this issue because this change will affect our future career paths,” Prem said. 
He said that though they understand why the OCSC has decided to stop allocating civil-servant posts, he also cautioned that by taking away welfare and job security, the commission was also eliminating the strong incentive that new doctors have to work in the public sector for low wages. 
“We know that the civil-servant positions are limited and the remaining spots will not be enough for all new graduates, but stopping the allocation of new civil-servant positions is wrong, because it will worsen the problem,” he said. 
Prem added that this lack of civil-servant positions was a problem created by the Public Health Ministry in its move to solve another problem – the lack of doctors in rural areas. 
According to the Medical Council of Thailand, the number of newly graduated doctors has risen over the past decade from just 1,250 new doctors in 2000 to 1,814 in 2010 and 2,662 in 2018.
“Since the authorities are trying to solve the shortage by producing so many doctors that there are not enough civil-servant posts for them to fill, they are also neglecting the existing doctors in the system,” Prem said. 
“The problems that discourage new doctors from working in rural hospitals are unpleasant working conditions and an overwhelming workload. Unless the ministry can solve these problems, the shortage of doctors in rural areas will continue being a problem, no matter how many new doctors the ministry produces.”
Chana Hospital director Dr Supat Hasuwannakit agreed, saying he too was concerned that more doctors will quit the public health system and work for private hospitals in the cities due to these “inappropriate policies”. 
“In the end, I suggest that the Public Health Ministry introduce reforms in its own administration, and stop relying on the OCSC’s civil-servant administrative system. This will ensure that our healthcare system can effectively manage its workforce to fit the real situation and guarantee good and fair working conditions for all medical workers so they want to remain in the public health sector,” Supat said.