The crisis over the mandatory placement of medical-profession graduates in Egypt is escalating, because the Ministry of Health and Population has replaced the placement system, moving from the automatic appointment of all graduates of dentistry, physiotherapy and pharmacy faculties to a new system based on the actual needs of health facilities, which has led to cutting the placement rate to cover only 45% of pharmacists, 40% of dentists and 25% of physiotherapists, alongside the delay in announcing the residency round, which had been scheduled for last December.
On 21 February, the Ministry of Health and Population announced the start of the coordination round for the placement of graduates of physiotherapy faculties of the 2023 cohort (first and second sittings), under the general electronic coordination system for the cohort, to work in the ministry’s units in the governorates and some other bodies, with distribution to be made according to grade totals, geographical distribution and the needs of hospitals.
The decision, which will be applied retroactively to graduates of the 2023, 2024 and 2025 cohorts, provoked widespread protests from medical syndicates and MPs, and graduates considered it a threat to their future, demanding placement for the full cohorts and the setting of clear and fair criteria for distributing human resources.
This comes about 4 years after the Supreme Committee for Placement approved continuing the placement of graduates of medical, nursing and health sciences faculties, for the 2022 cohort and after, according to the actual needs of the Ministry of Health, starting from the 2025 placement round, while rejecting the complete abolition of placement and committing to Law No. 29 of 1974.
The Ministry of Health and Population had announced, in August last year, the conditions of the doctors’ residency round for May 2025, which includes the December 2023 cohort and those before it, the most important of which are: completing one year of actual work for regular specialties and 6 months for urgent specialties, with the possibility of applying through the doctors’ placement website, provided that registration within the specified period is a basic condition to avoid it being considered a waiver of the residency.
The General Department of Placement Affairs at the Ministry of Health had approved, in September 2023, the completion of placement procedures for physicians, pharmacists, dentists and other medical categories who had been issued amendment decisions before the end of the two placement years and were unable to implement them because the period had ended, which include clearance and taking up work for those placed according to the placement amendment decisions within 90 days of the end date of the placement, with any period of interruption dropped from the length of service if the person placed is not assigned to a financial grade.
Like other graduates of physiotherapy faculties in Egypt, Khaled Abdel Rahman, who graduated as part of the 2023 cohort, feels anxious about his professional future because of the decision to cut placement, which he believes does not reflect the scale of the real need for physiotherapy services in Egypt; the country’s population is approaching 120 million, while the number of physiotherapy specialists does not exceed about 18,000, a figure he considers small compared with the growing demand for this specialty within the health system. He points out that physiotherapy is no longer a complementary service but has become an essential part of the course of treatment in many cases, such as bone and nerve injuries, rehabilitation after surgical operations and sports injuries, in addition to its role in dealing with chronic diseases and the rehabilitation of the elderly.
He tells Zawia3: “Many villages and remote areas lack sufficient physiotherapy units, which forces patients to travel to other governorates to get treatment sessions. This is a heavy burden on patients, especially since physiotherapy requires frequent and regular sessions that may last for weeks or months.”
From this standpoint, Khaled believes that placing graduates could help fill this shortage and improve the distribution of health services among the governorates, stressing that physiotherapy is not a medical luxury but an essential part of patients’ right to treatment, rehabilitation and regaining their ability to move and live their lives normally.
For its part, the General Syndicate of Physiotherapy in Egypt submitted an urgent appeal to the Prime Minister, Dr Mostafa Madbouly, demanding the placement of all 2023 graduates of physiotherapy faculties, after the issuance of the Supreme Committee for Placement’s decision, which was limited to only 1,366 graduates, stressing that changing the placement rules without a transitional period threatens investment in private, national and international education and negatively affects the future of thousands of graduates, at a time when state sectors such as university hospitals, primary care units and sports medicine units suffer from an acute shortage of specialists.
The syndicate demanded postponing the application of the needs-based placement system for 3–5 years and forming a joint committee of the Ministries of Health and Higher Education and the House of Representatives to determine the needs of the labour market, along with halting the granting of licences to new faculties and controlling the numbers admitted in line with work and training opportunities.
The anxiety and anger following the cut in the numbers placed were not limited to graduates of physiotherapy faculties; Sara Maher, a 2023 graduate of a public pharmacy faculty, explains that she and her colleagues belong to the last cohort that studied under the “old system” in pharmacy faculties, the system they enrolled in on the basis that government placement is an established right after graduation, stressing that applying the needs-based system to them represents a retroactive effect of a decision that did not exist when they enrolled in the faculty.
She explains to Zawia3 that her cohort was supposed to enter the 2024 placement round, while there was initially talk of applying the new system to later rounds, which made many feel that they had suddenly found themselves inside a decision they were not party to, and that they do not bear responsibility for the large expansion in establishing private and national faculties and the increase in the number of graduates in recent years.
She recalls that the long years of study and the great academic pressure she went through were aimed at obtaining a stable job opportunity that would allow her to earn a decent living, and then she and her colleagues were forced to wait three years after graduation in the hope of placement, calling on the government to reconsider the decision and place her entire cohort.
Her position is consistent with the statement of the General Syndicate of Egyptian Pharmacists, which stressed that the 2023 graduates waited about three years from their graduation until the placement round was announced, in violation of Article 2 of Law No. 29 of 1974, which stipulates the placement of graduates within one year of the date of graduation, which caused professional and occupational harm and affected their professional stability.
The syndicate rejected the decision of the Supreme Committee for Placement at the Ministry of Health to place only 45% of the cohort’s graduates, pointing out that some health institutions have announced their need to contract pharmacists, which indicates an actual need, and calling for the placement of the entire cohort and a reconsideration of the expansion in establishing private and national pharmacy faculties in line with the state’s needs.
The same situation is lived by Amr Mohamed, a 2023 graduate of a dentistry faculty, because of the open-ended wait of three years, as he and his colleagues still do not know what their professional fate is. He explains that their main demand is the full placement of the 2023 and 2024 cohorts, as it is their natural and legal right, especially since the admission and study rules continued for years under a stable system, and they were not notified from the beginning of any radical change in policy, considering that any new decision may not be applied retroactively if it will cause direct harm to graduates.
He asks: “If the state sees the number of graduates as a crisis, why did it continue to expand by opening private and national faculties without controlling the numbers or raising the minimum admission score? Students should not bear the consequences of the absence of prior planning after years of study and spending.. Is it our fault that we worked hard, studied and waited for a fair chance to work in our country?”
He points out that some health units in Luxor Governorate, where he comes from, do not include dental units at all, while other units have equipment without doctors, or more doctors than necessary in one location, considering that the real problem lies in poor distribution and management, and that the solution is not limited to cutting placement but requires developing the infrastructure, by providing equipped dental units nationwide, supplying them with the necessary materials, organising work in shifts and offering a service at suitable prices that encourages citizens to go to government units.
The executive board of the General Syndicate of Physiotherapy had instructed its legal department to file an urgent lawsuit before the administrative judiciary to challenge the decisions of the Supreme Committee for Placement, along with studying the legal mechanisms for joining the cases filed before the State Council by some members of other medical professions.
Solidarity moves that end in detention
Coinciding with the crisis, which provoked widespread protests by graduates on social media, the security services arrested Dr Mohamed Osama El-Sayed, a candidate for membership of the General Syndicate of Dentists (under-age seat), and Dr Mostafa Mahmoud Orabi, a member of the youth secretariat of the Mostaqbal Watan Party and a member of the medical committee of the National Front Party. According to rights defenders, they were brought on 25 February 2026 before the Supreme State Security Prosecution in Case No. 945 of 2026, and the prosecution charged them with spreading false news and joining a banned group and ordered their pretrial detention, against the backdrop of legal and solidarity moves organised by 2023 graduates to challenge the Ministry of Health’s decision to cut the numbers placed to about 40%.
Commenting, human rights lawyer Malek Adly, director of the Egyptian Center for Economic and Social Rights, stresses that a security approach to professional crises is not a solution but may aggravate them, considering that the moves by a number of pharmacy and dentistry graduates to challenge the Minister of Health’s administrative decision and demand their professional rights fall within the scope of freedom of expression and the right to organise, to union work and to resort to the courts.
He tells Zawia3: “Resorting to pretrial detention in such cases leaves a negative effect on the union climate and freedom of expression within the professional sectors, and sends intimidating messages that may obstruct public debate about health policies, at a time when the system needs an open dialogue about its crises.”
Adly believes that the ongoing controversy over cutting the placement of health-profession graduates and the delay in announcing the December 2025 residency round reveals, at its core, a crisis related to the absence of transparency and access to information; it is difficult to assess whether there is a shortage or a surplus of medical staff in the absence of clear official data on the numbers of doctors, their geographical distribution, and the number of health facilities and available beds compared with the population.
The centre’s director adds: “Saying there is a surplus of medical staff contradicts repeated complaints of a shortage of services in a number of areas, in addition to the continued emigration of doctors abroad in recent years, and the loss of medical talent represents a strategic risk connected to national health security.”
He stresses that the state is required to manage its health human resources efficiently, taking into account its obligations towards workers in the sector and citizens, and to bear in mind that health services are by their nature public services that should not be run on a purely profit-making logic, especially in light of the economic pressures borne by citizens, considering that addressing the crises of placement, training and emigration requires a comprehensive, data-based vision and respect for the constitutional rights of those working in the medical field.
Anger extends to parliament
In light of the placement cuts and the delay in announcing the December 2025 residency round, a number of members of the Egyptian House of Representatives submitted briefing requests and public discussion requests on the crisis of placement for medical-profession graduates, including dentistry, pharmacy, physiotherapy and doctors in general. These requests focused on the delay in issuing placement decisions, the cutting of numbers under the label “according to need”, the absence of transparency and poor planning in opening faculties without regard to the needs of the labour market.
The moves included several MPs, among them: Rawya Mokhtar, Irene Saeed, Nevine Iskandar, Freddy El-Bayadi, Safinaz Talaat, Hanaa Anis Rizkallah, Hossam Khalil, Mohamed El-Damaty, Sara El-Nahhas and Donia Hany Abdelaziz , who demanded transparent placement mechanisms, clarification of the needs criteria, fair distribution of graduates and the guaranteeing of their professional rights, in addition to setting a clear government vision for employing medical staff in a way that serves the needs of the state and the labour market.
For her part, MP Irene Saeed, a member of the Health Committee of the House of Representatives and head of the parliamentary bloc of the Reform and Development Party, criticises the Ministry of Health’s continued application of a system for placing graduates of medical faculties according to set percentages without discussing the briefing requests submitted by MPs on this file, pointing out that an emergency session of the Health Committee was supposed to be held given the sensitivity of the placement timing and its direct impact on graduates’ future, but these requests have not yet been placed on the agenda of discussions.
Speaking to Zawia3, she expresses her concern about the absence of transparency and equal opportunity in the mechanism for setting placement percentages, pointing to indications that many health bodies need larger numbers than those announced, at a time when the ministry later resorts to contracting medical staff to fill the shortage, considering that this approach raises questions about the efficiency of human resources management and may open the door to suspicion of wasting public money, especially since contracts are often more costly and less stable than the placement system.
She says: “Including the placement system in the bylaws of medical faculties pushes many families to bear high education costs on the basis that there will be a government job opportunity after graduation, which means that cutting placement without prior coordination with the Ministry of Higher Education puts graduates before an unexpected professional reality,” warning that not placing a large proportion of graduates may push them into unemployment or into waiting for limited opportunities in the private sector, which in turn suffers from a saturated labour market and a decline in some employment opportunities, especially in the pharmacy sector, and they may resort to emigrating to work abroad, an option that may not be available to everyone, especially women.
The MP criticises the current mechanism for ranking candidates for placement, which relies mainly on the grade or the total, considering that it may not necessarily reflect the actual competence of graduates given the differing assessment policies between public and private universities, which may lead to unfair results, and pointing to the lack of clarity of the figures the Ministry of Health relies on to justify cutting placement, and that it had previously informed the Health Committee that the application of the new system would begin with later cohorts and not the 2023 cohort, which makes changing the decision now a matter of political and oversight questioning.
For her part, MP Rawya Mokhtar, deputy chair of the Manpower Committee of the House of Representatives, explains that the continuation of a particular system for many years created a legitimate expectation among graduates that it would continue, and it may not be changed suddenly without clear justifications and a published study, criticising the Ministry of Health’s failure to provide a legal basis or a study for setting the placement percentages, the bases for estimating need or the size of the actual surplus.
She tells Zawia3: “I demanded that the government provide the House with a published planning study explaining the methodology for setting the percentage, data on the distribution of the shortage in health units nationwide, and statistics on the numbers of graduates over the last five years compared with the numbers of those who reached retirement age or resigned, as well as a statement on the availability of financial grades, the extent to which the decision is consistent with the philosophy of placement stipulated in Law No. 29 of 1974, and clarification of whether financial considerations were a reason for cutting the numbers.”
She believes there is a state of inconsistency, as the government announces that there is no shortage while at the same time continuing to expand by opening new faculties, questioning the extent of coordination between the Ministries of Health, Higher Education and Labour in determining the needs of the labour market before increasing the numbers admitted to medical faculties.
She warns that the continuation of these policies may contribute to increasing the rates of doctors travelling abroad, expressing her concern over the detention of a number of 2023 graduates among dentists and pharmacists because of their moves, and calling for a clear and fair vision that strikes a balance between the needs of the state and the rights of graduates and ensures the stability of the health system without stirring confusion in society.
Meanwhile, MP Nevine Iskandar, a member of the Social Solidarity Committee of the House of Representatives, stresses that the crisis of placement for graduates of dentistry, pharmacy and physiotherapy faculties is not new this year but goes back to previous years that coincided with the large expansion in establishing private faculties and national universities and the noticeable increase in the number of graduates; the Ministry of Health began some time ago to put forward the idea of cutting compulsory placement and moving to a needs-based placement system, which was the subject of repeated discussions in previous parliamentary sessions.
She tells Zawia3: “There is a legal violation related to the delay in announcing the placement round, as the law obliges the Minister of Health to announce the placement round within one year of the cohort’s graduation, while the announcement was delayed for nearly three years. This delay deprives graduates of a clear professional path and puts them in an unjustified state of waiting.”
She adds that the 2023 and 2024 cohorts enrolled in the faculties under a stable system that had been in force for years, based on placing all graduates, and therefore changing the rules after their graduation represents a breach of the principle of stability and equal opportunity. She points out that the Ministry of Health announced in 2020 that the needs-based placement system would be applied to students enrolling in faculties starting from that year, which means that the cohorts that preceded them should be subject to the previous rules they were accustomed to, the current ones, which reflects, according to her, a clear flaw in the management of the placement system.
She continues: “Parliament has received numerous complaints from graduates in various governorates expressing their concern about their professional future, and MPs submitted alternative proposals that could strike a balance between the needs of the state and not harming graduates, such as announcing the placement round in successive time phases instead of cancelling placement for part of the cohorts. They also asked about the criteria the ministry relies on in determining need, the absence of which raises questions about how to guarantee justice and equality among graduates of the same cohort, but the Minister of Health has not yet come to parliament to discuss them.”
She also points to a contradiction between the ministry’s talk of there being no need for additional numbers of pharmacists, dentists or physiotherapy specialists, and some hospitals affiliated with the ministry announcing their need for these specialties on a contract basis, which raises questions about the efficiency of the distribution of medical staff within the health system.
A shortage of doctors or a surplus beyond need?
Despite the widespread discontent in union and parliamentary circles and among graduates of pharmacy, dentistry and physiotherapy faculties affected by the decision, Dr Khaled Abdel Ghaffar, the Minister of Health and Population, appears to be insisting on his decision, as he stated on 3 March this month that the placement system will be applied in the coming period according to actual need, attributing the decision to studies that he said the Supreme Committee for Placement had prepared and the Cabinet had approved.
The minister stated that the number of pharmacists working at the ministry stood at 51,000 when the decision to study the matter was taken in 2022, while the number has now risen to 103,000.
Meanwhile, Dr Mohamed Alaa El-Din, Secretary-General of the Federation of Medical Professions, stated in media remarks that the number of dentistry graduates has now reached 120,000 dentists, that by 2030 we will reach 230,000 dentists, and that the number of graduates per year reaches 12,000.
A recent press report quotes Ministry of Health officials as saying that the number of dentists within the system rose from 28,685 to 47,299 in the period between 2022 and 2026, while the need was estimated at only about 3,175. The number of pharmacists also doubled from 51,286 to more than 103,000, against a need estimated at about 3,525, and the number of physiotherapy specialists increased from 8,808 to 18,411, although the announced need did not exceed 1,026.
On the other hand, statistics show that the rate of doctors in Egypt stands at 8.6 doctors per ten thousand citizens, that is, one doctor for approximately 1,163 citizens, while the global rate is about 23 doctors. According to the Central Agency for Public Mobilisation and Statistics, the number of doctors fell to 97,400 in 2022, compared with 100,700 in 2021, and according to the Egyptian Ministry of Health, about 9,000 doctors graduate annually, but more than 60% of them choose to work outside Egypt.
For his part, Dr Khaled Amin, a member of the council of the Doctors’ Syndicate, explains that physicians are still placed in full because of a continuing relative shortage in some locations, but the most prominent crisis appears among dentists, pharmacists and physiotherapists, as the Ministry of Health indicates that their numbers have exceeded the actual need and the capacities available within hospitals, considering that the crisis is linked at its core to the absence of comprehensive planning for the numbers admitted to medical faculties.
He tells Zawia3: “There is no published data showing the actual distribution map, whether in terms of the number of doctors compared with the amount of available equipment or their geographical distribution, and the ongoing debate lacks accurate and transparent figures that could be relied on to assess whether there is a real surplus or shortage.”
He adds: “Delaying or cutting placement should not be reduced to the job, especially given the low salaries; it relates mainly to the loss of opportunities for systematic training. Continuing to graduate large numbers without clear planning may lead to disguised unemployment and a decline in the level of professional competence, in addition to increased emigration rates and future difficulties in the recognition of professional competence abroad.”
He explains that placement is not merely a job opportunity but represents an organised training path in which the doctor is subject to administrative and technical supervision within public hospitals, ensuring the acquisition of practical experience under the oversight of older and more experienced doctors, noting that depriving graduates of this stage may push some of them to practise the profession outside an organised training framework, which may negatively affect the quality of health services and patient safety, and calling for a comprehensive planning vision that starts with regulating the numbers admitted to faculties, passes through linking medical education to market needs, and ends with guaranteeing a disciplined training path that protects doctor and patient alike.
Meanwhile, Dr Ayman Attia believes that setting the numbers placed according to the state’s needs may be justified from an economic standpoint, but the main problem lies in the fact that students were not aware of this change when they enrolled in faculties of medicine, pharmacy, dentistry and physiotherapy in recent years, on the basis that placement has been a stable system for decades, denouncing the failure to disclose at the time that there was an intention to change it.
He stresses to Zawia3 that the effect of the absence of placement is not limited to the matter of employment alone but extends to an essential aspect related to the practical training of graduates, especially since these specialties by their nature depend on combining theoretical study with clinical training under the supervision of more experienced doctors within hospitals, and work within public health institutions represents the main path for acquiring practical skills after graduation.
He says: “Depriving a large proportion of graduates of this training path may leave large numbers of them without a real opportunity to gain professional experience, and the private sector is not an easy alternative in this context, as private hospitals tend to contract doctors who have previous experience or training in public or university institutions, to ensure competent performance and reduce professional risks.”
He warns that the absence of an organised training path for graduates may lead to negative effects in the long term, both on their professional future and on the quality of health services, explaining that a doctor who has not received sufficient training may face great difficulties in practising the profession safely, which may ultimately affect patient safety.
But Attia believes that part of the background to the decision may be linked to economic considerations, given the difficulty of absorbing all graduates within the government apparatus, considering that addressing this issue requires prior planning and a clear announcement of new policies years before they are applied, so that students can make their educational and professional decisions on the basis of clear information.
In a related context, Egyptian President Abdel Fattah El-Sisi called for a review of the academic specialties that no longer meet the needs of the labour market, asking the Egyptian government to take clear decisions on the specialties that do not provide real employment opportunities, in order to protect students’ future and not waste years of their lives without professional return.
Amid this controversy over placement percentages, the crisis of placement for medical-profession graduates in Egypt reveals a deeper gap in health human resources planning and an overlap of powers between the institutions of education, health and the labour market.
Between graduates’ fears of unemployment or emigration and the government’s insistence on linking placement to actual need, the most important question remains how to strike a balance between the rights of thousands of young people who enrolled in medical faculties under a stable placement system and the capacity of the health system to absorb and train them efficiently?
Editorial correction: The first version of the report stated that the rate of 8.6 doctors per ten thousand citizens means “less than one doctor for every 500 citizens”; the correct figure is approximately one doctor for every 1,163 citizens.
