Foreign-trained SA doctors head to court over lack of internships

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InternsSome 105 foreign-trained medical doctors battling for internship placements are heading to court, claiming they are being side-lined, reports The Times. The Health Department, however, denies there are students who have not been placed.

The report says the Legal Resources Centre’s (LRC) Durban regional office has represented more than 200 doctors so far, and it is heading to court again in 2019.

Director Sharita Samuels said South Africa was in dire need of medical professionals, yet the system was frustrating junior foreign-trained doctors. “Earlier (in 2018) we represented 100 students who trained in foreign countries. We won the case, and at the start of the new year they are starting their internships at various hospitals,” she said.

“The country is in dire need of doctors mostly in rural areas, and yet the HPCSA (Health Professionals Council of SA) is denying them the chance to practise. These young doctors’ parents spent money to send them to overseas universities, yet their own country rejects them. (In 2019) we are representing 105 more on the same issue, and we are hopeful of winning the case.” Samuels said she was not sure about the total number needing placement, but “there could be hundreds”.

The South African Medical Association (Sama) said it was concerned by the “hurdle” faced by junior doctors. Board member Dr Rhulani Edward Ngwenya said: “It baffles me how such can happen when we have a dire need of doctors in this country.

“As per our updated database, there are 22 doctors awaiting placement in total – 15 community service doctors and seven interns. Two of them are foreign-trained. There may be many more that have used our platforms, so we don’t have a complete picture.”

The report says repeated attempts in the past two weeks to get a comment from the HPCSA were unsuccessful. But national health spokesperson Popo Maja said all South Africans who were eligible had been allocated. “This includes both Nelson Mandela-Fidel Castro programme graduates and other South Africans who studied abroad. The department does not have knowledge of any South African or permanent resident graduate who has not been allocated. A few did not like their allocation and have rejected the allocation.”

He said there was still hope, as there was another intake before 1 July.

The report says he would not answer the question of how many complaints they had received from student doctors who still needed internships, but said there weren’t any more accredited internship posts available to accommodate foreign-trained doctors who had passed their board examination. “There are no resources available to assist these applicants.”

Earlier this month, Health Minister Aaron Motsoaledi said his department was placing 9,797 newly qualified health professionals in internship and community service posts by 1 January. Of these, 1,883 were medical interns. “Over the years the department has experienced serious hardships with the placement of these entry-level professionals into the health workforce. The national health council has therefore dealt with this problem in an endeavour to breaking with the past,” said Motsoaledi.

Medical students must complete a compulsory two-year internship and a year-long community service stint before they can be registered as fully-fledged doctors. But three junior doctors are quoted in the report as saying they had qualified in 2017 but were yet to be placed. They wanted to remain anonymous, as they did not want to jeopardise their chances of getting placements.

One young woman said she applied to the HPCSA in 2017. “The entire 2018 I was doing odd jobs not related to my profession, as I was waiting to be placed. It did not make sense for me not to be placed. Last month, minister Motsoaledi has advertised these posts for interns and community services where we are qualified, but we are getting nothing, no explanation.”

Another student said she applied for an internship in August as required. The South African Internship and Community Service Programme now says it cannot trace her account.

Ngwenya said Sama had several engagements with health department officials. “We continue to engage them and voice the concerns raised to us. Ultimately, the final execution of demands made remains with the employer.”

The report says many of those affected studied at universities in Romania, Mauritius and China. Ngwenya said that to qualify for an internship in South Africa, they needed to have successfully completed an undergraduate medical degree at an internationally accredited institution.

“Thereafter one would have to write the HPCSA board exam. Upon successful completion of this, registration with the HPCSA and fulfilment of the necessary home affairs criteria, one would then apply to the national health department for placement to do an internship.”

A policy guideline document on the requirements for the practice of medicine in South Africa, signed by the Health Department in June, said students contemplating studies abroad must register as a student studying in a foreign country first with the HPCSA, as that helped them plan for students expected for internships.

“Graduates of foreign universities that are not recognised or approved by the HPCSA will not be considered as holding a qualification suitable for the purposes of registering as a health practitioner in South Africa.”


Sama says, meanwhile, that it is working around the clock to ensure all newly qualified intern and community-service doctors are placed and ready for duty at the beginning of January 2019. The Times reports that this after Motsoaledi announced in December 2018 that there was a “massive” recruitment drive in the healthcare sector.

The Health Department will spend R2bn to fill more than 15,000 posts for health workers across the country’s public health facilities. The new jobs included 9,797 newly qualified health professionals, such as community-service dentists, nurses, pharmacists and allied health professionals. Of the more than 15,000 posts, 5,300 will be clinical and support health workers across the nine provinces.

“We are aware of the over allocation of doctors at certain institutions that do not have the sufficient number of posts to employ them, such as Jubilee and Tambo Memorial hospitals. We have been engaging with the Department of Health on a regular basis and have been assured that all affected doctors are being reassigned to surrounding tertiary institutions,” chair of Sama Angelique Coetzee said.

Coetzee urged all affected doctors to contact the union should they need assistance.


“Understaffing, especially in the provinces, has been cited as one of the major contributing factors which has affected the provision of health care,” Motsoaledi is quoted in The Times as saying.

However, the National Education Health and Allied Workers’ Union (Nehawu), although welcoming the decision to fill the positions, said 5,300 posts were not enough to ensure that the sector performed at its best. The union added that the pace of filling the positions was too slow since President Cyril Ramaphosa had announced the stimulus package more than two months ago.

The Times report
The Times report
The Times report

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