Critical shortage of doctors in 2008
However, while government is fully 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 medical students to do a two-year internship after 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 stabilize 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 South African Medical Journal of the ‘possible tsunami effect of the two-year internship’.
Any medical student who graduates successfully after 1 July 2006, regardless of their university of origin or duration of undergraduate curriculum, has to undergo a two-year internship comprising of four months each of medicine, surgery, obstetrics and gynaecology, paediatrics and family practice or primary healthcare with ‘exposure’ to mental health. There is also a two month rotation though orthopaedics and orthopaedic trauma and two months through anaesthetics.
Reid and Prinsloo warned that the new programme would lead to radical shifts ‘ ‘a tsunami effect of doubling the number of interns was anticipated, in terms of its effect on posts, teaching and community service’ coupled with the drastic withdrawal of community service doctors in 2008 ‘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 antiretroviral treatment programmes are rolling out. ‘We will have to limit the number of people we can treat if we don’t have enough doctors,’ he warned.
Doctors, especially those working in rural hospitals, have expressed concern over the effect this dramatic withdrawal will have on their institutions next year. 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 health department to assist rural hospitals to expedite the registration of foreign doctors prepared to assist next year.
‘We need to recruit doctors now. The clock is ticking,’ Gaede said.
Health department spokesperson Sibani Mngadi confirmed that community service doctors would be reduced to no more than 356 in 2008.
Asked what the department was doing to address the 2008 shortfall Mngadi said: ‘Provinces are assessing their needs for 2008/9 and are considering a number of recruitment and retention options to retain doctors.’
However, he did not give further details.
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