South Africa needs about 1Â 000 doctors in the next 100 days to fill a year-long shortage of medical graduates caused by changes to their training programme.
In a neat twist to the normal direction of the medical brain drain, overseas doctors are being lured to South Africa with the promises of a great medical and cultural experience, the chance to make social contributions, fabulous scenery, game parks and beaches.
The problem has arisen because medical students now have to do a five-year, rather than a six-year, degree, followed by two years of community service instead of one. The changeover occurred this year. In January next year, only about 300 young medics will enter community service instead of 1 200 to 1 400 available in ‘normal†years.
Rural facilities in particular fear they will be left critically understaffed because they are heavily reliant on community service healthcare workers, who make up 50% of medical staff.
Remote healthcare facilities have difficulty in attracting staff voluntarily because of the physical isolation and the lack of resources and senior doctors to provide mentorship and training.
Doctors keen on building professional careers tend to stay near the academic centres where they can benefit from contact with more experienced doctors — even though a young doctor will get wider experience and greater responsibility in a rural facility.
Eighty percent of South Africa’s doctors are in private practice and doctors keen to make money also tend to prefer richer urban areas.
The national health department estimates that there will be a shortage of between 800 and 900 community service doctors next year. It says provinces have adopted a variety of strategies to fill the shortfall, including trying to retain the doctors already in those posts, recruiting doctors from abroad and asking general practitioners to help out.
Meanwhile, doctors’ organisations are stepping up efforts to recruit more rural doctors. The Rural Health Initiative (RHI) is a two-year-old project which focuses on bringing foreign doctors to South Africa and South African doctors home.
RHI has so far recruited 170 doctors and is processing another 140 applications. Of the doctors who have come to South Africa, 95 came from the United Kingdom, 25 were South Africans and the others came from the United States, Canada and Europe.
With next year’s doctor shortage looming, RHI, with the Rural Doctors Association of Southern Africa (Rudasa), has gone into an intensive social networking recruitment drive at home and abroad. The UK is a particular target because not only is it training many more doctors — seven new medical schools have been built in the past few years — but problems with the implementation of a new skills development system has left many qualified UK doctors frustrated and underemployed.
Rudasa vice-chair William Mapham says RHI is efficient in finding overseas doctors, often through personal contacts, and helping them with the application and registration processes. But the scheme is constrained by its pilot donor funding and hopes to develop a partnership with the health department. ‘They have the funding and RHI has the capacity; if they could give RHI that funding they’d be able to do the job together.â€