uk doctors in south africa

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REGISTRATION AND RECRUITMENT OF FOREIGN QUALIFIED DOCTORS

A proposal towards alleviating the crisis in rural hospitals

Background


Dr Ian Couper was invited to attend and address two conferences exploring international doctor exchanges, both organised by Locumotion, an Irish locum and support agency. The first was held on the 4th September 2001 in Utrecht, Holland, and the second was held in Dublin, Ireland, from 8th to 9th September. At both meetings there was a lot of interest among doctors regarding the possibility of working in South Africa. However most of these doctors were discouraged by the current registration requirement, i.e. by the need to write examinations.
Points to note

1. The crisis in staffing rural hospitals in S.A. is now well known. It will be a long time, if ever, before we are able to staff them entirely with South African doctors. In this context, note that in Australia after more than ten years of major effort, funding and directed training, the shortage of rural doctors is greater now than in 1990.
2. There are many doctors from Ireland, the UK, Holland, Spain and Australia that would be very interested to work in South Africa for a few years. Most doctors who have expressed interest are fully trained general practitioners with 3 to 4 years of postgraduate vocational training. They thus are qualified as the equivalent of a family physician in their country of origin.
3. Many doctors in these countries after completing their vocational training wish to take a few years off to experience another part of the world before settling down into a practice. On the other hand, many approach retirement age and want to do something different for a change, such as working abroad; they are ready and willing still to make a contribution for a number of years.
4. Ireland, the UK and Australia are short of GP’s and are actively recruiting from each other. This is a healthy exchange. Unfortunately they also recruit from S.A., our graduates being highly sought after, yet the registration requirements here minimise the possibility of any real exchange taking place.
5. Furthermore, Germany and Spain have excess doctors. Spain in particular produces 2000 vocationally trained GP’s each year and there are not enough jobs for them.
6. Interested doctors lose enthusiasm for working in our country when they hear they would have to write exams to register, even for short-term work; it is easier to get registered in other countries. It is interesting to note that in 1996 Australia introduced similar registration requirements involving exams, but because of the serious effects on rural areas, special allowances were made subsequently for “areas of need”, where doctors can get temporary registration for up to two years. In fact, most developed countries with a rural problem have introduced processes that make it easier for foreign doctors to work in rural areas.

Proposal

1. The HPCSA, through the Committee for General Practice, should review the programme for vocational training in general practice of any country from which doctors might usefully be recruited for South Africa.
2. Where this vocational training is found to be sufficient and appropriate, such training should be accepted as a fair and valid assessment for purposes of registration by the HPCSA
3. Foreign qualified family physicians/GP’s applying for registration who have completed such vocational training programmes should then be registered for public service without the need for further assessment.
4. As at present, work offers would be issued on the basis of need.
5. The possibility of using the government-to-government agreement that has existed with the European Union should be explored, in order to mount a recruitment drive in EU countries, with assessments being conducted by the HPCSA within the EU (as with Cuba) for those doctors who still need assessment.

No change in the HPCSA regulations would be needed to implement this process.
Motivation


We strongly believe from recent as well as past experience that such a process will enable South Africa to recruit well-qualified generalists for the public service from countries with the resources to train such GP’s and that this would make a big difference to the staffing of rural hospitals.