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After six years navigating the demanding path between lecture halls and university hospitals, Moroccan general practitioners finally graduate. That marks the beginning of a second phase, specialization. At this stage, they face a crucial choice: either become contracted doctors, employed by the Ministry of Health and Social Protection with a monthly salary, or declare themselves non-contracted, receiving a stipend of 3,500 dirhams, later raised to 5,000 dirhams following protests.
The flaw lies in the imbalance created by this dual system. Data shows that more than 80% of medical students choose the non-contracted status. In other words, they receive their education and training in public universities, fully funded and equipped by the state, only to head straight into private practice after graduation. They are, in essence, publicly funded students who end up serving private clinics.
The state trains them, pays them allowances, and then delivers them to the private sector on a silver platter of public money, while public hospitals continue to suffer from a chronic shortage of medical personnel. Meanwhile, students enrolled in private medical schools pay at least 10,000 dirhams a month for their education, only to find themselves working alongside their publicly trained colleagues in the same private clinics.
As for the small minority who choose to become contracted, many do not remain in the public sector. Once their training ends, they often seek to terminate their contracts in order to join private clinics. However, in doing so, the state requires them to repay double the amount they received in salaries during their specialization period.
Alternative Employment Institutions
At this point, private clinics emerge as the so-called saving angels. They offer to cover the repayment amount in exchange for the doctor’s commitment to work for them, often with generous salaries, reimbursed in comfortable installments. The result is that the contracted doctor effectively becomes a private-clinic employee, while the public sector loses yet another talent. In this way, private clinics have turned into alternative employment institutions, attracting doctors away from the state and into the hands of investors.
This silent crisis, one that neither the minister nor officials openly discuss, is in fact a key issue at the heart of health-sector reform in Morocco. The current balance between public and private healthcare must be re-examined. Public hospitals, as the foundation of national health services, should be the primary beneficiaries of the doctors trained in public universities.
Today, private clinics are expanding rapidly across the country, even in small towns. They no longer rely solely on new graduates; they also recruit doctors who continue to work in public hospitals, further draining the system’s already scarce human resources.
The public sector, which should form the backbone of Morocco’s healthcare system, has become a double victim, a casualty of poor policy management on one hand, and of the growing dominance of the private sector on the other. It now serves private interests more than public ones. Instead of complementing the public system, the private sector has become a dominant force benefiting from its workforce, training, and resources.
The challenges facing Morocco’s health sector are many and complex, but at their core lies a shortage of medical staff. Solving this issue should not take a decade and a half, as some officials claim. It requires bold decisions and clear regulations, laws that ensure doctors trained with public funds serve in public institutions for a minimum period, and that strictly govern the relationship between public practitioners and private clinics.
Yet instead of acting, officials appear on television to repeat what everyone already knows and what Generation Z protesters shout in the streets: «The sector suffers from a shortage of doctors». A crucial part of the solution begins with restoring the public hospital’s role as a vital institution serving the common good.
