Health

The Western Cape Government Health (WCGH) understands the need to broaden the base and increase the number of medical students in South Africa, with specific emphasis on rural areas. The Province is committed to increase the number of South African medical graduates.

The Western Cape Government health has in the past not participated in the Cuban Medical Scholarship programme. The Department has been consistent in indicating that there are other solutions available to the challenge the country faces. The problem to be addressed is both the number of medical students that are required to address the needs of the Country, but also the relevance of training, especially to have a more PHC and rural oriented training and exposure. In the past most of the medical student training happened in the tertiary settings. The further challenge is that the human resources plan indicating the number of medical doctors required in the country has not yet been concluded at a national level.

The Cuban training model has several shortcomings and challenges, one of which is the cost of training and accommodating students in a foreign country with a foreign language and disease profile, and to provide further training on their return to the country of origin.

The funding issue must be seen against the backdrop of the current challenge across provinces to appoint intern doctors are currently being trained in the country. An increased number of intern doctors from the Cuban programme will further exacerbate challenge provinces are currently having to accommodate the intern doctors trained in the country.  Provinces, furthermore, experience challenges to appoint qualified doctors due to the lack of funding available.

It must be noted that the allegations that the Western Cape Government has rejected the Cuban Doctors’ Programme based on ideological reasons are unfounded. The decision was made because of the unanswered concerns regarding the proposed return of investment:

• The students have to spend 6 months to a year of this programme learning Spanish, orientating themselves with the culture and the language of this foreign country before they can start with the medical curriculum.
• Upon their return to South Africa, they spend an additional three years being orientated into the South African health system at a South African Health Science Faculty before they can graduate and begin to practice as medical practitioners in South Africa.  This is in addition to the number of years they have spent studying their actual medical curriculum.  

What is the alternative?

1. Bursaries to medical students from rural communities
2. International evidence is that students that come from rural areas, are more likely to return there once qualified. To this effect the province has over time provided XXXX bursaries to students recruited from rural areas.
3. Rural exposure and training of medical students
4. International evidence is that students who training in rural areas are more likely to stay in these rural areas. The US has been working with the province since 2001 in its Ukwanda program. The UCT has also recently commenced on this journey. There are currently 40 students training in the rural settings. The academic outcome of these students is excellent and the PHC orientation is enhanced. In the metro, a large number of medical students are also training outside the tertiary settings.
5. Increasing the number of undergraduate medical students being trained

6. The Western Cape Government Health has initiated a process with both the Universities of Cape Town and Stellenbosch to develop strategies to significantly increase (possibly double) the intake of MB ChB students at these two universities over the next 10 years. This will require innovative approaches from both the Department and the Universities. We are of the opinion that this offers an alternative to the Cuban initiative. A proposal will be made to the National Minister of Health in this regard.

It would seem that training our own medical doctors here at home makes better financial sense while it equips our students with the appropriate South African experience. Investing in health sciences faculties (medical schools) and strengthening the service platform where clinical training happens across the country will take us a step closer to meeting the demands of producing qualified doctors and redressing the injustices of the past by widening access to previously disadvantaged candidates in a sustainable way.