Some junior doctors struggle to find jobs, but aspiring medics are not deterred 

NCDs: 'World has lost focus during COVID-19 pandemic'
South Africa has been producing more doctors. (Photo: Freepik)
NCDs: 'World has lost focus during COVID-19 pandemic'
South Africa has been producing more doctors. (Photo: Freepik)

The plight of junior doctors who struggle to find employment with the National Department of Health after completing their community service has become a regular feature of the South African news cycle in recent years

In a statement issued by the DA Spokesperson for Health, Michele Clark, she says, “Last year September it was revealed that of the total number of doctors who completed their community service in 2023, only 60% or 1 187 were appointed into funded medical officer posts in government facilities. That means that 40% had to find a job in private health care or were forced into unemployment or emigration.

But this has not detracted bright matriculants entering their first year of medical studies, who hope to contribute to their communities. 

Rural healthcare challenges inspire career choice

Sinethemba Gangatha (19) is one of the country’s top achievers in the matric class of 2024. He is also one of the thousands of first-year students about to kick off the journey towards becoming a doctor, a dream inspired by a personal tragedy.  

Nothing will stand in Sinethemba Gangatha’s way of becoming a doctor. (Photo: EC Department of Education)

Growing up in Magxabasini, a deep rural village in Flagstaff, it was not easy to access health services. Villagers had to spend about R80 to and from the hospital which is 60km away from his village. 

“I was 12 years old when I watched my grandmother fight for her life in 2013. She raised me and my four siblings with the eldest being 16. My mother was in Johannesburg hustling for employment opportunities. There was no money to take my sick grandmother to the hospital. Because we were still young our neighbours helped to bathe and feed her,” he says. 

He says one day when they came back from school his grandmother had died in her bed. He later learnt she died from diabetes. 

“I knew I wanted to pursue a career in medicine. I had to do it for my village and my grandmother,” he says.

But the path to realising this dream is filled with obstacles such as delays in securing employment upon qualification. This is a grim reality for millions in a country with an unemployment rate of 32.1%, the highest unemployment rate among the G20 member states. 

Gangatha tells Health-e News that he has seen how junior doctors have to fight for job opportunities every year.

“But this does not mean the country does not need doctors, especially in rural areas where one doctor sees thousands of patients. I know it won’t be easy but we have to make a difference in people’s lives” he says. 

Mihlemihle Manyange,18, from Lower Wodehouse in Cofimvaba the top matric learner from St James High at Chris Hani East district says she has always dreamt of being a doctor. She has been accepted at Wits University.

Mihlemihle Manyange would love to open her surgery in the future. (Photo: supplied)

“The challenges in the healthcare sector will always be there. Maybe the government should make it easier for doctors to start their surgeries [private practice] by loaning them the capital they need. It would make life easier for the elderly who will not have to travel far to access healthcare and to be assisted closer to home. I always dream of opening my surgery here in my village,” she says. 

Between giggles, she shares that she can’t wait to be the first doctor from her village. 

Thorny issue of unemployed junior doctors

South Africa has been training more medical doctors. For example, the number of medical graduates doing internships increased from 1472 in 2018 to 2210 in 2024. But the government, as the largest employer of doctors, has been struggling to absorb the additional healthcare professionals.   

In a 2024 statement addressing the issue of unemployed doctors, then-health minister Dr Joe Phaahla acknowledged that the pressure on the allocation of government funds has made it difficult to employ everyone because the department had faced budget cuts which, in turn, limited the availability of employment opportunities. Phaahla said between January and March 2024 there were 1121 medical officers at Grade 1 entry level who were employed. 

A 28-year-old junior doctor from Limpopo who asked to remain anonymous says she completed her Community Service at Edenvale Hospital in December 2024. 

“I applied at various government hospitals with no luck. Where I worked, there was a shortage of doctors but I was told there’s a budget shortfall. I now find myself desperate and squatting at my cousin’s place because I could not afford to pay rent in January. The money that I saved will help with groceries and my child’s creche fees,” she says. 

She says as the breadwinner at home she is willing to work as a cleaner or a driver. 

“I don’t know how long I will have to wait to be employed. My younger brother recently passed matric and my sister graduated in language practice but they can’t come to stay with me to look for greener pastures because I don’t have a space of my own,” she says. 

Last year Health-e News reported extensively on junior doctors looking for employment. Since then, most of the doctors we spoke with found employment. 

Department must step in 

“The consequences of this situation are far-reaching and have significant implications for the delivery of healthcare services. The unemployment of junior doctors not only affects the individuals themselves but also has a ripple effect on the entire healthcare system,” says South African Medical Association chairperson Dr Mvuyisi Mzukwa

He says this exacerbates the existing shortage of medical personnel leading to overworked and burnt-out healthcare professionals. 

“This compromises the quality of care provided to patients and puts a strain on the already overburdened healthcare system,” Mzukwa says. 

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SA Medical Association Trade Union (SAMATU) general secretary Dr Cedric Sihlangu says the union has engaged the Department of Health to highlight the dire consequences that the department’s lack of strategy in retaining doctors post community service has on the public health system.

“Each year, successive Ministers of Health have acknowledged the gravity of this situation and the need to develop concrete strategies that would curb this issue from persisting. But we are yet to see a plan from the department,” he says. 

“The Department of Health invests substantial resources during the two-year internship and one-year community service to develop these doctors. It is perplexing that the department, having made such considerable investments, neglects to nurture and retain these invaluable assets within the healthcare system,” Sihlangu says.

The union urges the Ministry of Health to urgently develop and implement a comprehensive strategy. 

Repurposing funded posts

Health spokesperson Foster Mohale tells Health-e News that the department, working with provinces, continues to advertise posts for various categories of health professionals, including doctors. 

He says the department is investigating vacant funded posts in other categories that could be repurposed as critical health posts.

“The bottom line is that the budget of R62 billion which was allocated to the Department of Health in July last year remains a factor for the department to appoint every health professional in the public sector at the current moment. The department plans holistically when allocating budget for various programmes for effective health system,” he says. An additional budget of R3.7 billion was allocated for the payment of workers and also to address the wage bill.  – Health-e News 

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