Medical students in the province have openly revolted against a new programme aimed at placing them in KwaZulu-Natal’s rural areas for internships. According to a report in The Mercury, the students told KZN Health MEC Sibongiseni Dhlomo that they did not want the programme because it was not equipped to accommodate their needs.
Fifth-year medical students representative Phumelele Yeni said: “We firmly state that the final-year students of 2017 should not be subjected to this programme.” She said more than 100 students held a meeting in November and signed a petition voicing their opposition. “We are extremely unhappy with the programme based on our experiences,” said Yeni.
The report says the revolt is threatening to cause disruption at the university and put the health programme in disarray, and shut down opportunities for students to do their practical work. It will also deny thousands of rural people access to medical treatment by doctors.
Student Representative Council secretary at the school of medicine, Tumisang Moleke, said the SRC was inundated with student complaints. “You cannot send out students to a place that does not have simple things that we have here in Durban. “Before we pressure students into moving there we need to provide adequate resource to enable the students to perform to the best of their abilities,” he said.
Moleko claimed that student leaders were pressured into accepting the programme at the beginning of the year, adding that this has had a negative effect. “Issues were only solved superficially, and we cannot continue to treat symptoms. We just treat something and next week we are complaining again.
“Where do students go when they have academic problems? Where do you go when you have funding problems? The resources are in Pietermaritzburg or Durban,” he said.
Provincial health deputy director-general responsible for specialised services and clinical support services, Lindiwe Simelane, insisted that “no matter what, the programme will continue”. “At this point there is no going back,” she said.
Other students said they were happy with the programme.
Health MEC in Limpopo province Phophi Ramathuba, former president of the South African Medical Association, said the government was working hard to address students’ concern about the programme. “Decentralising the programme assists us in making sure doctors get to be distributed throughout the country. Every doctor wants to work in the city, and you will find that there are too many of them in the city,” she said.
Dhlomo told the students that making sacrifices for the good of their communities should be viewed as a priority. According to an IoL report, Dhlomo was speaking to students and other stakeholders at the Nelson R Mandela School of Medicine during a seminar on the Decentralised Clinical Training Platform (DCTP) for students, the first of its kind in the country.
The programme is a joint venture between the provincial health department and UKZN and seeks to increase the number of “fit for purpose” medical students exiting the facility each year.
According to the DoH, South Africa is in need of an additional 20 000 doctors.
DCTP places students in accommodation for up to two weeks in areas near to hospitals, clinics and other facilities, with a focus on rural areas and primary health care facilities. The country has an existing programme, initiated in 2013, where South African students are taught in Cuba but receive clinical training upon returning to South Africa.
According to Professor Fanie Botha, UKZN will receive 340 students returning from Cuba in 2018 that need to go through local clinical training. In 2019, an additional 280 students will return from Cuba. All of the students will have to be absorbed into training programmes.
With an upgrade of South Africa’s medical training programmes, it is hoped that students can be trained on home soil and increase the number of fit for purpose doctors needed, particularly in rural areas.
The report says the seminar offered a platform for students who had taken part in pilot programmes around the province to give feedback.
Students involved in health sciences such as dental therapy and optometry weighed up the positives and negatives of their experiences and said they found the programme exciting and informative. “A two hour drive was worth it because we got to interact with people in rural areas who had never before seen a health care practitioner,” said optometry student Mohammed Dandri.
Dhlomo conceded that the department had to “plead” with medical students to do a rotation in distant, rural hospitals, and the answer was simply “No, I am not going there. I will do my rotation at King Edward (hospital)”. He said that some of the best medical training he received was from nurses in rural areas.
He acknowledged that the programme had challenges with infrastructure, wifi access and distance to shops and said that these would be addressed. It would be impossible to have 500 final year medical students rotating around an urban, well-equipped facility like King Edward, he said.
“If you are doing an internship at King Edward, you do not learn as much as you would if you were sitting at KwaMagwaza Hospital in Melmoth,” he said.
Doctors had to be faced with survival situations and exposure to various communities and medical situations was vital. “In rural settings, you get an opportunity to see raw pathology. You will be the first health care professional to deal with it. The learning that you get in these facilities is unparalleled,” he said.