Health: Despite taking a number of measures to address the issue, retention of medical specialists still remains a challenge according to the civil service annual report for 2015-2016.

“The country still faces critical shortage of medical specialists,” the report stated.

Retention of medical specialists for the commission has still proved an uphill task in spite of taking number of reform measures.

As per the report, at least nine medical specialists have left the profession over the period of five years while those in the service are still filing resignations. “A few of them are also on extraordinary leave (EOL),” the report stated.

As of June 30 this year, medical specialists on extraordinary leave made 1.70 percentage of total 317 civil servants who availed EOL.

The report stated that one reason the medical specialists are unhappy with is the significant differences in the pay of national and expatriate doctors. The expatriate doctors are paid around USD 1,500 per month. Whereas the Bhutanese medical pofessions as per the 2014 civil service pay scale are paid Nu 239,95-311,95 at P3 depending upon the seniority and qualification among other criterion. The doctors entering the civil service at P4 are paid between Nu 213,70-277,45. “But at the same time, it has also become increasingly difficult to find expatriate doctors at USD 1,500 since it is considered meager for medical professionals.”

The commission has, therefore, directed a task force comprising of specialists and management team to prepare a proposal to address the monetary gap. “The commission will finalise the proposal prepared by the task force and it will be submitted to the government,” the report stated.

According to the report, as part of reform to retain the medical professionals, the commission approved entry of medical specialists at P3. Earlier, the entry level for specialist was at P4.

As a long-term solution, the commission has already started earmarking specialist slots for critical medical fields to send MBBS doctors for the specialisation courses as soon as they are inducted into the civil service. This method is to fast track production of medical specialists. “Further, medical specialists can also enter directly at P3 civil service salary level if private candidates with specialised masters degree are willing to join civil service in the required areas,” the report stated.

Meanwhile, the commission reviewed doctors’ career path to explore ways to make up for the seniority doctors lost because of long term study like MBBS, Bachelor of Dental Surgery and masters to motivate the serving medical professionals to perform better. This is also aimed to make medical profession in general more attractive given that the demand of medical professionals will increase with the growing number of aging population.

The commission would fast track medical specialists promotion depending on the seniority. “Doctors with masters degree will be given entry at P3 while study period of more than two years will be considered as active service for promotion.”

Furthermore, the commission also extended its reform measures to consider study period as active service for even doctors pursuing specialization at Khesar Gyalpo University of Medical Sciences of Bhutan.  “This encourages doctors to study in-country and has the double benefit of their continued practice that benefits the Bhutanese society at large while also upgrading their skills and qualifications,” the report stated.

This reform implemented from July 2015 is going to benefit 210 doctors at P2 and below. As of now 18 doctors have been promoted after the reform came into effect.

As per the report the number of civil servants in medical and health service group stands at 2,945. Though the number of civil servants leaving civil service dropped to 497 in 2015 from 1,078 in 2012, the number slightly increased to 541 by June 2016.

Tempa Wangdi