Explaining the issue, Dr G. Srinivas, resident doctor and member of HRDA, cited the example of three new medical colleges, one each in Suryapet, Mahbubnagar, and Siddipet, and the Telangana Institute of Medical Sciences (TIMS) in Hyderabad, receiving an insufficient number of applications despite having vacant posts. The reason being the contract clause, as contract recruitment is not preferred because once a doctor goes on contract, there is only renewal but no permanent job.

Further, the zonal system gives preference to health care workers of a particular zone or area. However, there are not enough doctors in all the zones for the posts.

In the letter, they notified the organization of local cadres or classes of posts in the new multi zonal system for direct recruitment in the health department as per the order of the Union Minister of Home Affairs and also requested to consider assistant professor posts in teaching medical colleges as State cadres post excluding from multi zonal system.

In the letter, the association stated "there is a need for recruitment of health care workers like doctors, nursing staff, paramedical staff and many are not willing to join under contract recruitment."

The letter further stated that "as there is a dire need of requirement of HCWs to meet the demands in present COVID-19 pandemic to treat the patients in both rural and urban areas and health care workers are reluctant to join through contract recruitment, there is need to do direct permanent recruitment. Hence, Sir, we urge you to notify the organization of local cadres through GAD for the direct recruitment of HCWs in the interest of public health emergency."

The association also shed light on the issue that there are very few medical colleges and affiliated teaching hospital hence the association urged to consider assistant professor post in teaching medical colleges as state cadre posts excluding from multi zonal system.

Dr. G. Srinivas, resident doctor and member of HRDA, told Deccan Chronicles that "Contract recruitment is not preferred as once a doctor goes on contract, there is only renewal but no permanent job. If this policy is not changed, these new medical colleges and TIMS will not have doctors joining them."