The Bhutanese Leading the way.
The main crisis facing Bhutan’s health sector is the loss of medical professionals like doctors, nurses, technologists and technicians.
The JDWNRH, which is the only central referral hospital of the country, has seen 92 resignations of medical professionals in 2025.
This includes 1 specialist, 6 MBBS Doctors, 74 nurses, 4 Allied Technologists (Pharmacist, Physiotherapist, dental surgeon, lab technologist etc with BSc degree) and 7 Allied Technicians (without BSc but Diploma like X-Ray and lab technicians etc ).
The numbers will go up as 45 more medical professionals have given their resignation notice of six months in 2025 and these include 1 MBBS doctor, 36 nurses, 4 Allied Health Technologists and 4 Allied Health Technicians.
Numbers will again go further down as 31 more staff have given their notice to go on Extra Ordinary Leave (EOL). These include 2 specialists, 3 MBBS Doctors, 10 nurses, 5 Allied Health Technologists and 11 Allied Health Technicians.
Why EOL numbers are important is because less than half of those going on EOL join back in the system, as most of the ones going on EOL are going abroad to work.
JDWNRH already has 67 medical professionals on EOL. These are 5 specialists, 3 MBBS Doctors, 39 nurses, 5 Allied Health Technologists and 15 Allied Health Technicians.
Adding more pressure on the numbers are those on Long Term Training of which there are 38 and they comprise of 7 specialists, 1 MBBS doctor, 15 nurses, 10 Allied Health Technologists and 5 Allied Health Technicians. This is more promising as they usually come back and work but the shortage is still felt in their absence.
The resignation numbers of 2025 have come down slightly from 2024 when 109 medical professionals resigned, however, the numbers still show a high trend of resignation that picked up from 2023 onwards after the pandemic. These 2024 numbers included 3 specialists, 8 MBBS Doctors, 73 nurses, 8 Allied Health Technologists and 17 Allied Health Technicians.
When medical professionals were asked reasons for resignation the reply was usually further studies followed by family issues.
When translated it usually means they are going abroad for more lucrative opportunities.
The loss of medical professionals has left an increasing gap between approved and actual numbers of medical staff in JDWNRH.
The approved number of specialists and sub-specialists is 171, but the existing number is 127 with a gap of 44. Even from this existing number 5 are on EOL and 7 on LTT.
Similarly, the approved number of nurses in JDWNRH is 881 but there are only 703 nurses with a gap of 178 nurses. Of the 703 existing nurses 39 are on EOL and 15 on LTT.
The approved number of MBBS Doctors are 49 but there are 42 with a gap of 7. Among the existing 42 doctors 3 are on EOL and 1 is on LTT.
Among other clinical professionals the approved number in JDWNRH is 515, but there is 486 with a gap of 29. Among the existing 486 there are 20 on EOL and 15 on LTT.
The numbers above don’t show another major issue which is the loss of experienced nurses, doctors and technicians.
Another aspect is even if numbers are filled up with fresh recruits a significant portion of them will head out once they gain some experience as per the current trend.
An official said a potential solution that is being looked at is creating a separate career ladder of medical professionals so that they can join at a different level and progress up instead of the current civil service system.
When asked why medical professionals cannot be paid significantly higher than other civil servants to retain them, Dr. Kuenzang Wangdi, the Director of National Medical Services said if their pay is increased beyond the peg to the civil service then other sectors will make noise. This is unless health professionals become a separate service.
