The housemanship programme is a fundamental training process that every aspiring medical graduate has to go through in order to obtain the full registration licence to practise medicine in Malaysia. In recent years, there have been signs of problems with regard to the housemanship programme: among them, longer waiting periods for houseman postings, complaints of mental stress and fatigue when performing houseman duties, and cases of housemanship extension and dropouts due to incompetency. In this study, we explore and examine the government’s policies in medical education provision and accreditation as well as the strategic planning for the housemanship training programme in Malaysia. Our findings indicate that there is an oversupply of medical graduates from both local and foreign institutions contributing to the shortage of housemanship positions. The rapid proliferation of local private medical institutions in Malaysia is the primary cause of the housemen ‘glut’ in the system. In addition, we also scrutinize the medical programme recognition and accreditation process undertaken by the Malaysian Medical Council. The turnover of housemanship positions has declined over the years, with only 58.8% housemen from the 2014 batch successfully completing their training within 2 years. We also argue that the competency issue of some housemen, which commonly leads to extension of programmes, is likely derived from some poorer performers from foreign medical institutions; approximately 60% of housemen dropouts are medical graduates from foreign institutions. Finally, the study serves as a timely policy review and a call for the government not just to provide short-term remedies but more importantly, to carry out prudent strategic long term planning for medical human resources in Malaysia.