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It was his dream to become a medical doctor. For six years he worked hard and did not enjoy life like students in other disciplines, thinking it was worth it to rather stay home and study. But now that he is qualified, he has no job and is thinking of selling his car because he cannot afford to pay for it anymore.
During his two years of internship, he toiled away in a state hospital notorious for its lack of everything that doctors in private hospitals take for granted. When he had to do his community service year, in a small rural hospital far from the city, he did not complain.
Now this 27-year-old doctor – who wants to remain anonymous to protect the small chance he still has to get a post at a state hospital so that he can specialise – feels trapped. He sent in 25 applications last year to state hospitals because he cannot specialise at a private hospital.
“It would have been easier if the department would let private hospitals take in registrars who want to specialise. The doctors at state hospitals who have to oversee us usually have private practices at private hospitals and they would be able to oversee us there too.”
His wife is doing her community service year currently and then she will also probably be unemployed. Newly qualified doctors do not have many options, he says.
He is prepared to work anywhere in South Africa, even at the smallest, most remote hospital, but there is no place for him. His wife will be prepared to join him next year.
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However, he considers himself one of the lucky ones who only had to take out a student loan for the last year of his studies and he owes R98 000 on it. Other students still owe the full amount of R500 000 and they also do not have jobs.
If they work as locums, where they stand in for general practitioners at their practices, they get paid very little and have to work long hours. Not that they are scared of working long hours – their internships and community service prepared them to work much more overtime that is allowed and they do not get paid for extra hours.
Should he choose to become a general practitioner, he will need a few hundred thousand rand to buy equipment and it takes up to five years to start turning a profit. He wrote a business plan and a bank is prepared to lend him the money he needs to start a practice, but that is not his dream.
Is he sorry that he even had this dream of becoming a doctor? “Two years ago, I would have said maybe I made a mistake. Now, after seeing how fulfilling it is, but also how heartbreaking it can be, how the job can beat you down, I am still happy with my choice.”
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Health minister Joe Phaahla spoke to the media last week to explain why so many newly qualified medical doctors cannot be employed by the state. He admitted that 694 of the 800 unemployed doctors just completed their community service but said government cannot employ them because entry level doctors must be paid R1.2 million per year and the department cannot afford the wage bill.
This young doctor does not agree. He says the entry salary is R908 000 and new doctors are required to sign a five year contract and work 140 unpaid overtime hours.
He is not happy that about 50 Cuban doctors are employed in state hospitals, saying they hold back posts that should go to South African doctors.
Phaahla also mentioned that the annual claims for negligence against hospitals in only one province can pay for all the unemployed doctors to be employed for a year. The young doctor says this is because doctors who are employed in state hospitals are so overworked that they make the wrong calls which lead to claims against the hospitals.
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He also believes that negligence claims are not always settled for the correct amounts. He knows of a case where a child’s broken arm was put in a cast before the child was sent home with his grandmother. The family never noticed that the child’s arm was swelling and when they brought the child back to the hospital, his arm had to be amputated. A negligence claim of R60 million was paid out in the end.
Although he feels sorry for the child, he questions how the damages of R60 million were calculated.
Corruption also eats into hospital budgets. It was reported last year that a total of R1 billion was stolen just from the Tembisa hospital, where for example, the hospital paid R9 600 for a plastic bucket. This money could have paid for a thousand doctors for a year.
The young doctor says state hospital management is often to blame because money is wasted.
“Where I worked before, management only ordered sterile gloves at R80 a box, while normal gloves cost R50 per box. We had to use only sterile gloves because the other gloves were not available.”
He and his wife are now considering to go and work in the UK or Canada although they would love to stay in their home country. But to do this, they will also have to fork out close to a R100 000 to write the tests necessary to practice in these countries. All the doors out of the trap they find themselves in just lead to more debt.
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