Recent radiotherapy graduates have been waiting six months to be placed at a health facility where they can see out their obligatory year-long community service. In South Africa, healthcare professionals are required to complete a one-year community service programme at government facilities after graduating, before they are allowed to join the workforce.   

Health-e News spoke with four radiotherapy graduates who studied together at the University of KwaZulu Natal. They completed their studies in November 2023 and had hoped to start their internship by 1 December 2023. But they are still waiting to be placed. 

‘’We spent the last 4 years studying consistently and developing our skills to become radiotherapists and to provide the best care for our patients. This is what we are trained to do and as per the procedure we were meant to be doing our community service at this point,’’ says Isa Khan* (22) from Durban in Kwa-Zulu Natal. 

Earlier this year the National Department of Health said it had received a total of 10 386 applications through the Internship and Community Service Programme (ICSP) online application system. A total of 9 395 applicants were successfully placed. 

Khan completed her Bachelor in Health Sciences in radiotherapy in 2023 but is still unemployed and was not placed for community service for the first intake in January. There are two internship and community service cycles – an annual cycle and a mid-year cycle. 

The group says it’s had no feedback on the status of their applications.  If they do not complete their community service it is impossible for them to be employed as radiotherapists. 

‘’The lack of communication from the ICSP has also made it difficult for us to take up jobs on the side because we were given hopes that any day we could be placed in health facilities to start our comserve,’’ Khan says.

Progress delayed

When they enquired with the National Department of Health about when posts would be available, they were told to wait till 1 May 2024 to apply for the July 2024 intake. But there are still no posts available. 

These young professionals say there are opportunities for them in the private sector. But the government is holding them up with no hope that things will get better. 

Khan argues that, as radiotherapists in South Africa, they should not be forced into unemployment because there are fewer hospitals that offer radiotherapy in the public sector. 

‘’We have cancer patients who are still awaiting radiation treatment and there are hospitals that are still short-staffed. It’s very disappointing to be honest. It’s a waste of our skills and expertise for us to be unemployed,’’ she adds.  

‘’A shortage of skilled personnel such as radiation oncologists and radiation therapists  poses a significant obstacle in offering radiotherapy services to cancer patients in the country,’’ says Dr Ernst Marais, the COO of Icon Oncology, a network of private providers of cancer treatment. 

He further says, to address this current challenge, the private and public sector need to come together and develop a workforce strategy and use the available expertise. However, he says, there is a hurdle in bringing together these two sectors. Medical graduates need to serve a year in a government facility before they can move to the private sector, should they choose to. 

Bottlenecks in the system

Lionel Foster* (22) from the Western Cape says that he has reached out to private radiation practices with the hopes of doing his community service there. But they could not assist him because the Health Professionals Council of South Africa (HPCSA) and National Department of Health are the only bodies in charge of community service. The private sector does not have have the HPCSA’s approval to offer internship programmes at their facilities. 

‘’We are not allowed to apply for posts in the public sector as we need to do community service first to be awarded our independent practitioners certificate by the HPCSA,” says Foster who completed his studies in December 2023. 

‘’I had to pay the HPCSA registration of R1500 in January and another R1500 in April, yet they haven’t done anything to help me get community service placement which will allow me to get  my independent practitioners certificate and I can apply at any private or public facility. If I try to email them the email bounces back or they just never respond to it.”

Moreover, he says that he still has a student loan that he has not been able to pay. He had made a payment agreement with the hopes that he would be able to make monthly payments once he started with comserve. Unfortunately things haven’t gone as he had planned. 

Nolwazi Nkosi* (24) from Nelspruit in Mpumalanga lays  frustrations squarely with the Department of Health, because the mid-year intake of radiotherapists did not happen.

Nkosi graduated in December 2023 and says that she is actively looking for employment. But every door she knocks on keeps referring her back to community service, which can only be done in a government facility.

‘’Each time I go to the Department of Health to enquire about radiotherapy posts I am told to call hospitals and ask if there are any posts and if they are willing to take on more health professionals. I don’t understand why we have to do all this because it is their job,’’ she says. 

From the rural outskirt of Eshowe in Kwa-Zulu Natal, Bianca Smit* says that she’s asked about possible posts at the hospital she was training as a student for the past five months, there are still no available posts. 

‘’If the government allowed us to apply for community service in the private sector I would have applied just after my graduation,’’ says Smit.

Hoping that the government will provide more funding and avail more posts is what these graduates hold on to. –Health-e News

*Not their real names