Bangladesh has enough doctors. Why are hospitals still understaffed?

On 7 September 2026, Health Minister Sardar Md Sakhawat Husain told the parliament that Bangladesh requires 88,909 doctors to meet the World Health Organization's minimum threshold of 0.5 physicians per 1,000 people. 

Government hospitals, however, employ only 30,311 doctors. So, there is a national shortage of 58,598 doctors across the government hospitals. 

But another figure paints a more perplexing scenario. Bangladesh Medical and Dental Council data list around 134,568 registered general doctors—although some may have retired, emigrated or left practice.

It shows that Bangladesh may still need more active doctors to provide adequate universal healthcare. But, the bigger concern is that the country produces doctors whom the state does not recruit, while public facilities remain desperately understaffed. 

Therein lies the most troubling paradox of our healthcare system. 

Too few posts, yet too many vacancies

According to figures the health minister presented at the parliament in June, 5,782 of the 13,211 doctor posts at upazila health complexes were vacant—nearly 44%. At union sub-health centres, 670 of 1,314 posts were empty, a vacancy rate above 50%. 

It means that Bangladesh has not even filled the limited positions available now.  Of the 41,806 sanctioned posts, 11,495 are vacant. The problem becomes more acute as one travels further from Dhaka.

An earlier DGHS Health Bulletin painted an even grimmer picture. Dr Taufique Joarder, associate professor and lead of the Programme Evaluation Unit at the SingHealth Duke-NUS Global Health Institute, said its 2022 upazila-level data showed only 4,341 doctors occupying 10,471 approved positions. The remaining 6,130 posts, about 58.5%, were vacant.

"The situation has not improved much since then," he said. "It is neither just a supply issue, nor an issue of creating new posts. The simplest solution is to fill the existing posts—around a 60% vacancy rate for doctors in upazilas."

The paradox of unemployed doctors and empty hospitals

Medical colleges continue to graduate around 10,000–12,000 doctors every year, according to Prof Syed Abdul Hamid of Dhaka University's Institute of Health Economics.

"There are enough doctors in the system," Prof Hamid said. "The immediate priority is to ensure that the existing posts in the public sector remain filled. There are around 13,000 vacant posts, so we need a continuous recruitment process to fill them."

Infograph: TBS

Some unemployed doctors accept extremely poorly paid private positions simply to remain in clinical practice.

"There are many unemployed doctors, and some are working in the private sector for as little as Tk15,000–20,000 a month," he said. "You cannot even find a driver or domestic worker for less than Tk20,000 in many cases, yet doctors are working for Tk15,000–20,000 because there are not enough opportunities."

Research presented at a 2025 policy dialogue organised by the Alliance for Health Reform placed the average annual income of a Bangladeshi doctor at around Tk3 lakh and that of a nurse at Tk1.9 lakh—the lowest reported averages in South Asia. 

At the same dialogue, Bangladesh's average doctor income was compared with around Tk16 lakh in India, Tk98 lakh in the United Kingdom and many times more in advanced Asian health systems. Nurses in India were estimated to earn about Tk6 lakh annually—more than three times the reported Bangladeshi average. 

Mass recruitment is not a long-term fix 

Bangladesh has recruited thousands of doctors recently, but mostly through emergency-style drives.

In February 2022, during the Covid-19 crisis, 3,957 assistant surgeons were appointed through the 42nd Special BCS. The 48th Special BCS produced another large intake in 2026: 3,263 doctors and dentists formally joined, including 2,984 assistant surgeons and 279 assistant dental surgeons. A larger number had initially been recommended or processed, which explains why some official accounts put the batch above 3,400.

Together, the two drives brought more than 7,200 medical and dental officers into government service. General BCS examinations added smaller numbers, while some MBBS graduates bypassed clinical careers altogether and entered administration, police, foreign affairs and other cadres.

Yet thousands of vacancies remain.

Why? Because sporadic mass recruitment cannot replace a mechanism that fills posts continuously as doctors retire, resign, pursue training or leave for other jobs.

"We don't have any policy continuity in the health sector. Our ministry officials are brought in from different departments unrelated to health. So, they don't know what policies and strategies have worked or failed."

Dr Taufique Joarder, Associate Professor, SingHealth Duke-NUS Global Health Institute

Prof Hamid argues that the BCS is fundamentally unsuited to routine health recruitment.

"The general BCS process is clearly inappropriate because it involves a preliminary examination, followed by several stages that take considerable time," he said. "Even a special BCS is time-consuming—it can take nearly a long time from the examination process to appointment."

He suggested reforming the BMDC licensing process into a rigorous competency examination with a qualifying threshold and continuously updated merit list. When a government vacancy arises, the recruitment authority could draw qualified candidates from that list and complete selection through an interview and verification process.

"This would create a continuous recruitment mechanism," he said. "Whenever posts become vacant, recruitment could take place from the existing qualified pool rather than waiting for another BCS cycle."

Even after the BCS process is completed, bureaucratic delays can prevent recruits from joining promptly.

Dr SM Ziauddin Hyder, special assistant on health affairs to the prime minister, acknowledged that gap. He said, "Even after someone is appointed, it can take a long time for them to formally join".

"We need to find ways to reduce these administrative delays," he said.

It is hard to assign doctors outside Dhaka 

Bangladesh's formal posting rules require government doctors to complete rural service. In practice, transfers, attachments, deputations for higher studies and political or bureaucratic lobbying have repeatedly weakened those requirements.

Dr Joarder said Bangladesh has no dedicated national rural-retention policy, although provisions exist across health-workforce strategies.

"We don't have any policy continuity in the health sector," he said.

"Our ministry officials are brought in from different departments unrelated to health. So, they don't know what policies and strategies are already in place, what developments have taken place in the past, what decisions were made on rural retention, or what has worked or failed."

A newer health-workforce strategy was reportedly developed around 2025, although its formal status and implementation remain unclear. Dr Joarder suspects many officials responsible for implementation may not even know it exists.

Posting doctors by force without addressing their working and living conditions is unlikely to succeed.

Dr Shakhawat Hossain Sayantha, dean of the Dental Faculty at Bangladesh Medical University, said Bangladesh's doctor-distribution problem reflects the extreme concentration of national life in Dhaka.

Outside the capital, doctors may lack secure accommodation, quality schools for their children, professional opportunities for spouses, reliable equipment, personal security and access to postgraduate training.

"Why do doctors want to stay in Dhaka despite the congestion, air pollution, traffic jams and all the difficulties of living here?" he asked. "The reason is that, outside Dhaka, they do not have the same access to secure housing, suitable schools, colleges and universities for their children, or decent places for their families to shop and spend their leisure time."

Dr Sayantha supports making recruits sign an undertaking to serve wherever they are posted and preventing lobbying for preferred stations. But the state must uphold its side of the bargain.

"The doctor must be able to maintain a reasonable standard of living, professional standing and status within society, and a suitable working environment wherever they are posted," he said. "Simply policing doctors or exerting pressure on them will not solve the problem."

Prof Hamid goes further. He argues that rural retention cannot be solved while doctors remain trapped within a general civil-service pay structure. He proposed a separate Bangladesh Health Service like Britain's National Health Service. Like the separate judicial service, it would have its own recruitment, pay, allowances and promotion structure. 

"If doctors remain within the civil service, it is difficult to pay them substantially more because everyone is tied to the same grade structure," Prof Hamid said. "If the government wants to provide substantially higher compensation, they need to be placed outside the general civil service and given a separate professional-service structure."

More doctors alone will not build healthcare

Dr Joarder agreed that Bangladesh should continue producing and recruiting doctors. The 0.5-per-1,000 threshold is a floor, not the mark of an adequately staffed system. But expansion requires three safeguards: quality, appropriate distribution and a better skill mix.

"For every doctor produced, at least three to four nurses must be produced," he said. "There was a discussion around developing nursing schools with every new medical school. But that did not materialise."

Bangladesh's health-workforce structure remains severely unbalanced. A 2026 government-funded study placed the combined density of doctors, nurses and midwives at 12.78 per 10,000 people, far below the benchmark it used. The country has expanded medical education without proportionately building the nursing, midwifery, diagnostic and community cadres required for team-based care.

The consequences are felt by patients. Dr Zia Hyder said, "We already have shortages across almost every area. There is also an issue with our curriculum, which is outdated and needs to be upgraded. We need to ensure that the training and competencies required for primary healthcare are properly incorporated."

What the government is thinking 

The government has announced the immediate recruitment of 5,000 MBBS doctors and plans to hire another 100,000 frontline health workers. It has also created 941 senior staff-nurse posts and 947 midwife posts.

Dr Zia Hyder said, "The government has plans to develop a different system modelled on the NHS. The government intends to merge approximately 41,000–42,000 health assistants, family welfare assistants and community healthcare providers, currently divided among three directorates, into a unified Community Health and Wellbeing Worker cadre." 

The longer-term ambition resembles a primary-care gatekeeping system.

"The NHS model is already there as a reference point. Every ward in every city should have a primary healthcare unit," Dr Zia Hyder said. 

"These units would serve as the first point of contact, similar to a GP or primary-care doctor. Patients with more serious illnesses could then be referred from the primary healthcare level to higher levels of care."