Duhok doctors protest stalled appointments, warn of growing strain

DUHOK — A group of junior resident doctors and recent medical graduates protested in Duhok on Sunday, calling on the Kurdistan Regional Government to appoint the 2023–2024 graduating class, whose placements have been stalled for months.

The protesters read out a formal statement, urging swift action and warning of mounting disruptions across the health care system.

Under the Kurdistan Region’s healthcare system, new graduate doctors are typically appointed immediately as junior residents and rotate between different hospitals for two years. They then progress to a compulsory rural posting for one year before entering specialty training.

That cycle has now been disrupted due to issues with federal budget allocations from Baghdad. Because of the appointment delays, 2023–2024 graduates have not entered the system, leaving current junior residents and those in rural posts unable to advance. Without completing these phases, doctors cannot obtain licenses, pursue specialization or work in private clinics.

Jamal Kocher, a lawmaker from Duhok and member of Iraq’s parliamentary finance committee, told 964media that under the current framework, the Kurdistan Region requires both Baghdad’s approval and a federal budget allocation to hire new personnel.

“The Iraqi government also cannot appoint anyone unless it is included in the budget,” Kocher said. He added that while the Kurdistan Region could request the inclusion of doctors in the 2025 federal budget, “for now, the Iraqi government does not intend to do so.”

Muaf Karim, chief of the Diwan at the KRG Ministry of Health, said formal negotiations are underway. “The KRG Council of Ministers has formed a committee to negotiate with Baghdad and the Ministry of Finance to make appointments possible,” he told 964media.

“We want these new graduates to be appointed through Baghdad. But if Baghdad fails to respond and we lose hope, the KRG will go forward independently,” he added.

Karim said unappointed doctors were scheduled to meet with Health Minister Saman Barzanji on Sunday. “Everything will be clarified for them,” he said. As for residents who have exceeded their term limits, Karim said a decision is expected in the coming weeks.

Doctors said many residency contracts expired on Dec. 10, 2024. “We have continued working for six months beyond our term — 30 months in total — without disruption or official recognition,” they wrote in a joint statement.

2024 graduates have also been left in limbo, unable to enter the healthcare system. “We studied for over 18 years with the expectation of serving our people,” the statement continued. “Now, we’re left without a clear future. This also delays advancement for those ahead of us in the system who can’t move forward until we take their place.”

“It’s all a chain. Everything is connected,” one Duhok-based doctor told 964media, noting how delays at the entry level ripple across the entire medical hierarchy.

The bottleneck has affected more than just the latest cohort of graduates. Many of the protesters were appointed as junior residents in December 2022 and should have moved on by December 2024. Without incoming replacements, they remain in limbo.

Because the new class has not been appointed, junior residents cannot advance to a mandatory one-year rural posting. In turn, those in rural postings cannot leave to begin specialty training or practice freely in the field.

Doctors warned that if this cascading backlog is not resolved, hospitals may be forced to reduce services or shut down wards due to staff shortages.

The freeze is tied to ongoing budget disputes between Baghdad and the Kurdistan Regional Government. Since July 2024, no new hires can be added to the KRG payroll without federal authorization and budgetary allocations. If the KRG proceeds independently, it must fund salaries from its own revenues, as those hires will not be covered under the federal budget.

For many in attendance today, a confirmation from Baghdad that no appointments would be made this year marked a breaking point. In Duhok, where the workload is reported to be especially heavy, some doctors reported clocking in over 250 hours per month. One participant warned of a growing strain: “Junior residents are carrying the weight of a collapsing healthcare system.”