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Internship set to cut intake of doctors
Anso Thom - IOL
2007-05-18

Rural doctors are bracing themselves for a crisis in hospitals next year, as the number of community service doctors is set to drop dramatically to around one-quarter of the usual intake.

However, while the government is aware of the impending crisis, it appears to have no back-up plans to find additional doctors for 2008.

The reason for the shortage is a change to the medical student curriculum, which now makes it compulsory for students to do a two-year internship, instead of the customary one-year internship before doing community service.

Community service doctors are increasingly the backbone of rural and underserved hospitals. Currently, some 1 400 community service doctors are assigned to hospitals every year, but this number is set to drop to 356 next year.

The situation will stabilise again in 2009 once the new system has been implemented, but managers at rural hospitals are bracing themselves for a disastrous 2008. Two years ago, Professors Steve Reid and Adri Prinsloo, of the universities of KwaZulu-Natal and Free State respectively, warned in a letter to the SA Medical Journal of a "possible tsunami effect of the two-year internship ... analogous to the recession of the water from the beaches before the tidal wave".

A KwaZulu-Natal doctor said the timing could not have been worse, as anti-retroviral treatment programmes are being implemented. "We will have to limit the number of people we can treat ..." he said.

Doctors, especially those working in rural hospitals, have expressed concern over the effect the reduction of staff will have on their institutions next year. The government has also not communicated with them about measures being taken to avert the shortage of doctors.

Dr Bernard Gaede, chairperson of the Rural Doctors Association of SA, said that his association had written letters to the health department, but had received no response.

"It is being left up to the individual hospitals to recruit doctors. The silence from the health department has been deafening," he said.

Gaede urged the department to assist rural hospitals to expedite the registration of foreign doctors prepared to assist next year.

Asked what the department was doing to address the 2008 shortfall, spokesperson Sibani Mngadi said: "Provinces are assessing their needs for 2008/09 and are considering a number of recruitment and retention options to retain doctors."

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