Stethoscope and graduate hat.

SAMA has expressed concerns about plans to shorten medical
internships from two to one year, saying it rejects the proposal in its entirety.
The shortening of the programme was recommended earlier this year by the
Department of Health and the South African Committee of Deans (SACOMD) in a bid
to free up posts at training hospitals to accommodate the increasing number of medical
students graduating in South Africa and abroad, especially Cuba.

SAMA convened a stakeholder meeting at the end of last month
to discuss its concerns about the plan that could take effect after 2020. In a
statement, the Association says SACOMD suggested that the one-year internship
and one-year community service should be part of a vocational training
programme coordinated by universities. The committee further said, it was not
the purpose of the internship programme to allow medical interns to gain
competencies in surgical procedures such as Caesarean Sections and the
administration of anaesthesia

“This problem was created by the introduction of the Nelson
Mandela Fidel Castro Medical Programme which presented many new doctors – who
are due to enter the healthcare system in January 2020 – without proper
logistical and budgetary provisions from the Department of Health,” SAMA says.
This has caused a lack of accredited posts and funds to pay the increasing number
of interns.

At the stakeholder meeting, the HPCSA confirmed that the
internship programme would remain as a two-year programme in 2020. SAMA has
agreed to chart all currently accredited internship facilities. However, all
training platforms for internship training at regional hospitals are currently
saturated, and the Education, Science and Technology Committee (EST) of SAMA
have requested specialty societies involved in internship training to apply
their minds on how they could expand existing platforms without compromising
training.

“There are various models being proposed which include an
18-month regional/tertiary hospital rotation and a six-month district hospital
rotation. The expansion of the platforms may also include the accreditation of
new sites. SAMA would also urge societies to be mindful of less resourced
provinces to ensure that there is equity when new sites are proposed, or when
existing sites are expanded,” SAMA noted.

According to the Association, it will be engaging with the
national Department of Health on an ongoing basis to motivate for funding for
the additional internship posts.

Another option the SAMA EST supports is a distributed
platform of training from the regional hospitals to district hospitals/primary
healthcare (PHC) facilities. This option may facilitate better support for
district hospitals and PHCs from regional and district hospitals respectively.
Other options include integrated longitudinal eight-months rotations for three
blocks. None of these options has been formally adopted by the HPCSA.

SAMA has requested interested parties to submit suggestions
and comments on ways to improve the system. These can be forwarded to Karlienp@samedical.org