August 6, 2025
THIMPHU – Over the past few years, Bhutan’s hospitals leaned on Bangladeshi specialists to plug critical gaps in services. At their peak in 2020, 19 of them worked across the country’s public health facilities, performing surgeries, managing critical care, and mentoring local physicians. Today, only two remain – one paediatrician in Samtse and one nephrologist at JDWNRH in Thimphu.
Recently, both the Bangladeshi surgeon and the gynaecologist at Bajo Hospital in Wangdue resigned.
A source told Kuensel that this is driven by a combination of factors – job insecurity and a lack of long-term prospects in the country.
Expat doctors face an uncertain professional future in Bhutan, with contracts often renewed yearly, creating an atmosphere of instability.
An expat doctor described multiple cases where contracts were abruptly ended or not renewed without explanation. “That kind of uncertainty makes long-term planning impossible and discourages foreign doctors from fully investing in their work or integrating into the local health system.”
The lack of pathway to permanent residency, unlike countries such as Australia or Canada, which actively offer skilled workers and their families long-term settlement options, also discourage long-term commitment.
“Our intention is not to seek citizenship, only permanent residency – a stable status that would allow them to stay and contribute meaningfully to the country over time,” said an expat doctor. The huge pay gap between expatriate and local doctors has also bred quiet resentment with many Bhutanese doctors questioning the value of pursuing costly specialist training.
A Bhutanese specialist earns between Nu 70,000 to Nu 90,000 a month (around USD 850 to USD 1,000) while their foreign counterparts, performing the same duties, earn over four times more, with salaries ranging from USD 4,000 to USD 4,500.
In this wake, Bhutanese doctors are increasingly looking abroad for better pay and future prospects. Nurses, too, are leaving, with many bound for Australia, where the promise of permanent residency and higher living standards outweighs anything on offer at home.
A source said that many are counting the days until they complete their bond period so they can leave.
Meanwhile, fewer young doctors are enrolling in specialist training programmes.
According to World Health Organisation, a country should have one general duty medical officer (GDMO) per 1,000 people, and one specialist per 5,000. With a population of around 790,000, Bhutan should have at least 790 GDMOs and around 158 specialists. Currently, Bhutan has just 211 medical officers and 121 specialists.
In response to Kuensel’s queries, the Ministry of Health (MoH) shared that the recruitment of 19 Bangladeshi specialists in 2020 was a temporary measure to address immediate gaps in specialist services. These doctors were engaged on two-year contracts while Bhutan focused on strengthening its own medical workforce.
The MoH stated that all foreign doctors completed their contracts and no premature departures have been recorded. It stated that several expatriates have reapplied for extensions and many have left Bhutan with lasting friendships and goodwill.
According to the ministry, 87 Bhutanese doctors have also since completed specialist training, reducing reliance on foreign hires.
Additionally, a Bangladeshi government policy that restricts overseas employment for its doctors to five years has accelerated the departures.
On salary disparities, the MoH rejected the notion that pay differences create friction, highlighting that Bhutanese doctors benefit from long-term incentives such as gratuity, provident fund, housing, clinical allowances, and international conference opportunities.
Moreover, the ministry pointed out that Bhutanese doctors are often trained on full government scholarships, whereas expatriate specialists are paid market-competitive rates reflective of their home countries’ standards.
Regarding contract length and job security, the MoH stated that foreign specialists are offered two-year contracts, extendable based on performance and hospital needs. This, the ministry argued, ensures flexibility while supporting knowledge transfer and national capacity-building.
Although the MoH does not currently conduct structured exit interviews, it has begun collecting email feedback from departing foreign doctors. However, the ministry said responses so far have been limited in detail.
On the possibility of offering permanent residency or similar incentives to foreign doctors, the MoH clarified that this falls outside its mandate and lies with the Ministry of Home Affairs.
The ministry also proposed the Career Pathway and Performance Management System (PMS), which was submitted to the Royal Civil Service Commission in February this year. The PMS aims to provide clear career progression, performance-based incentives, and expanded training opportunities to improve morale and long-term retention.
The ministry is exploring formal Memorandums of Understanding with foreign governments and institutions to facilitate smoother recruitment and sustained collaboration.