Seventy percent of foreign-trained doctors who wrote board exams in October 2023 and February 2024 failed. But around 250 junior doctors who sat down for the theory paper say they discovered discrepancies in their board examination scripts. 

Now the group has written to the Information Regulator to compel the Health Profession Council of South Africa (HPCSA) to release their scripts.

The junior doctors have been supported by the South African International Trained Health Professionals Association (SAITHPA)

“We have been trying to access the scripts when we realised there was a high rate of doctors who had failed. The University of KwaZulu-Natal (UKZN) only gave them an hour to view their scripts. In that short period of time, they managed to see discrepancies,” says Advocate Rene Govender, on  behalf of the association. 

Foreign-qualified doctors must write and pass this exam before they are allowed to practise medicine in South Africa. Previously these medical board examinations were administered by  Sefako Makgatho University. Last year the HPCSA signed a new contract with the UKZN to manage these exams for the next three years. 

Govender says, previously they would get video and written recordings of the exams. She says an application to get a full examination record was made last year after the first board exams in October. The HPCSA declined that, stating that copy rights to the examination records are held by the UKZN. 

“Suddenly when the exams moved to UKZN, they didn’t want to provide us with these recordings. HPCSA is saying we can have the viewing of the records but the time is limited. The few junior doctors who had the opportunity to see their records were not satisfied and they complained about discrepancies,” she says.

She says when the exams were written at Sefako Makgatho University the pass rate was between 60% and 80%. 

“[Recently] the HPCSA confirmed that they will not release the examination records in the format that we requested (video and written records), which is allowed in terms of the legislation,” Govender says. 

When approached for a comment, UKZN said all queries regarding medical board exams have to be referred to HPCSA as the custodian of the exam.

Hopes dashed 

Among the junior doctors who want to see their scripts is Themba* who studied at Astrakhan State Medical University in Astrakhan, southern Russia. He was part of the group of junior doctors who marched to the offices of HPCSA in September 2023  after the council failed to conduct board exams for foreign-trained doctors because of an expired contract. 

Themba sat down for his board exam in October 2023. Two weeks later was informed that he had failed. 

“I was excited when HPCSA finally allowed us to write. However, the scope of the exams was changed seven days before we wrote. It was not the one they had previously sent. HPCSA sends you a scope of the exams 30 days before the exams,” Themba tells Health-e news. 

To write the board exams he had to pay R12 000 which was paid for by the government that sponsored his studies. Re-writing the exams would cost him an additional R12 000 that he would have to pay from his own pocket, which he cannot afford.

“Most of the junior doctors are coming from disadvantaged backgrounds and it will be a struggle to come up with R12 000. It feels like we wasted seven years of our lives and we have nothing to show for it,” he says. 

The group consists of doctors who trained at universities in China, Russia, Mauritius, and Italy funded by the provincial governments of Mpumalanga, Free State and Gauteng. 

“We were funded by the government for seven years. This qualification was meant to change our lives for the better. However, we are sitting at home frustrated and not knowing what our future looks like,” says Themba. 

Another junior doctor Tumelo* from Mpumalanga says she graduated in 2022 at Sechenov University in Russia and also had to wait for two years to write the board exams. 

“I studied in Russia and it was sponsored by the Mpumalanga government. This was a life changing opportunity for me as I come from a disadvantaged background. However, now I depend on my parent’s pension grant. I can’t even buy myself toiletries and on top of that I have to raise another R12 000 to rewrite the board exams so I can be able to work as a doctor,” she says. 

Janine, another junior doctor who studied in Russia, says she first wrote the board exams in October and was told she had failed. 

“It was a difficult exam and I felt that some of the questions asked could be answered by someone who is already practising. However, I did my best and I was disappointed when I was told that I had failed. I made an appeal to HPCSA through my lawyer and I had to wait for the results,” she tells Health-e News. 

Janine says while waiting for the results of the appeal, she registered to rewrite the exams in March.

She tells Health-e News that she had to pay another R12 000 to write the board exams which she passed. 

“I also discovered that I had passed the first exam and I am now fighting to get my refund. I feel very sorry for those who were told they failed their exams and there is nothing they can do to follow up. What is happening is a crying shame as the health system is crying out for doctors,” she says. 

Protecting the public

An official in the national health department who spoke to Health-e News anonymously, as this is an HPCSA issue, says that some provinces send students to study medicine abroad without checking the alignment of what is offered there with the local requirements. 

HPCSA spokesperson Priscilla Sekhonyana says the council has a mandate of protecting the public. 

“It is important for the council to administer the medical board examination as a form of evaluation to assess whether foreign qualified applicants possess the knowledge, skill and minimum competence to practise their profession. Failure to pass board exams may imply among others that the quality of training obtained by foreign qualified candidates may not be of the required standards set by the medical and dental professions board.”

She adds that practitioners holding foreign qualifications must submit the foreign curriculum for review by the professional boards. 

“This is to establish whether the education, training standards and the duration of study undertaken is equivalent to the education and training standard awarded by South African educational institutions,” she says. – Health-e News

*Not their real names