SA doctors say lack of training biggest threat to medical profession - survey

Local doctors have pointed to insufficient training as the number one problem facing doctors in the country, according to a new survey released by PPS.

The survey of almost 700 medical professional doctors found that 40% of respondents believe that insufficient training, staffing levels (33%) and ageing infrastructure (17%) are the biggest problems hindering the local medical profession.

Gerhard Joubert, Head of Group Marketing and Stakeholder Relations at PPS, says the result is not surprising. “The number of doctors who can be accommodated by medical schools in South Africa is not enough to train the required number of doctors needed by the country. In fact, the eight medical schools in the country only have the capacity to train 2 000 first year students.”

According to Mark Sonderup, Vice-Chairman and Phophi Ramathuba, Public Sector Chair of the SA Medical Association, South Africa currently graduates 1 300 doctors per year. If the accepted norm of 1 doctor per 1500 population were applied, an extra 12 500 doctors would be needed to staff a fully functional National Health Insurance (NHI) system were it implemented today.

While it is positive that Health Minister Aaron Motsoaledi has called on all medical schools to admit an additional 40 first year students each year, this increase alone cannot resolve the critical shortage of doctors in South Africa, says Joubert.

When asked whether current training standards of medical students is appropriate to the requirements of the healthcare sector, only 44% said yes, down 9 percentage points quarter-on-quarter.

Professor Alex Van Den Heever, Chair of Social Security at the University of the Witwatersrand Graduate School of Public and Development Management, says although the training of health professionals has only recently received some priority from Government, there is still no national platform in place to plan and deliver a new human resource strategy. “By ‘platform’ what is required is a well governed institutionalised approach at the national level to annually develop human resource strategies (i.e. sustainable plans which include targets on a multi-year basis) together with related conditional financial transfers to provinces and higher education institutions. The transfers must have sufficient specificity to ensure the attainment of the strategies.”

On a positive note, 66% of SA doctors agree with the principle behind the NHI initiative, up 7 percentage points quarter-on-quarter and the highest response for this question since it was first asked a year ago.

Joubert notes it is encouraging to see that doctors are feeling more confident about NHI as they will play a critical role in the successful implementation of the initiative and ensure the success and sustainability of the proposed universal healthcare system.

As part of the roll-out of NHI, the Department of Health is contracting with private doctors to work part time (for payment) at rural public health facilities known as NHI pilot sites. When respondents were asked whether they would be prepared to enter into such an agreement, 49% said yes.

“While this statistic is not as high as we had hoped, it is understandable given the likely salary knock doctors would have to take in order to oblige with the agreement,” says Joubert. “However, it is encouraging to see that it is not well below the 50% mark and reveals that doctors are willing to help make the NHI initiative work.”

Other results from the survey revealed that 71% of doctors believe that the community service year for qualifying doctors should be compulsory, while 36% of respondents said this period should in fact be longer.

It makes sense that respondents would encourage more time in the field to ensure adequate training of young doctors when compared with the other results of the survey, says Joubert.

“This survey of medical doctors has raised some pertinent issues about the education and training of doctors in the country and it is imperative that these findings are taken into account in order to improve the sustainability of the medical profession,” concludes Joubert.