External degrees stymie medics

The Health Professions Council of SA (HPCSA) has “systemically snubbed” at least 380 South African doctors
trained abroad, meaning they are not working, despite the country desperately needing doctors.

According to the South African Internationally Trained Health Professionals Association (SAITHPA), not only has the HPCSA reneged on its commitment to allow the foreign-trained doctors to write board examinations, but it has also demanded proof of internship the applicants cannot not produce.

The nonprofit organisation, which represents SA citizens with medical and allied health degrees from foreign institutions, is worried the New Pathway Guideline prevents internationally qualified doctors from practising in the country.

This regulation, according to SAITHPA, demonstrated the HPCSA’s inconsistency and double standards as it has applied the rules differently for graduates who applied to write the board examinations in the past.

In 2019, after six years of study in China, Geremie Nayager, 26, of Durban graduated as a medical doctor at Anhui Medical College, China, but did not anticipate his degree will be shunned by his country of birth.

In an affidavit filed in the High Court in Pretoria in December, he said his determination to become a doctor drove him to succeed.

“Due to our impoverished condition, I had to attend 13 different schools, moving every time my mother found work, employed mostly as a casual labourer in factories.

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Despite these circumstances, I tried my utmost to maintain good grades,” Nayager said.

In 2012, after completing his matric, he applied to several local universities, but he did not get in so he accepted an offer to study at the Chinese university.

This after he was assured by the HPCSA that for registration with the HPCSA he would be informed whether he needed to write a board examination.

Now that he has qualified and made financial sacrifices, the New Pathway Guideline demands he produces proof of internship.

He does not have this because of difficulties with getting a work permit and because China prioritisesd its citizens for internships.

“It is well known, as in the case of all medical students who study out of their countries, that they will not be able to provide a certificate of internship from the country in which they have studied, as they had student visas and not work permits to enable employment for internship,” advocate Rene Govender, SAITHPA’s lawyer, said.

She said even when the internationally trained doctors were allowed to write the board examinations, these were unfairly pitched beyond their level of training.

“While SAITHPA acknowledges the improved percentage results in the board examinations… it is still deeply concerned that they are pitched at the level of specialist medical practitioners and practising physicians,” Govender said.

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She said despite this challenge, their graduates have debunked the view held by government departments that they are incompetent.

According to SAITHPA, in March 2019, the HPCSA informed some graduates that their application to write the September 2019 board exam was deemed noncompliant on the basis that the institution from which they obtained their basic medical degree was “not evaluated by the relevant medical and dental board previously”.

The majority of affected applicants obtained their qualifications from universities in China, Romania and Guyana.

When SAITHPA threatened court action on behalf of its members, the HPCSA requested a stay of legal action and on 16 August, 2019, a decision was taken to permit them to write the board examination in March and May 2020.

But the organisation said the HPCSA backtracked on this decision and consequently legal action was launched in the
High Court in Pretoria.

Govender said their graduates had been invited to volunteer at private healthcare facilities which had rated their competency positively.

President of the HPCSA professor Mbulaheni Nemutandani said the New Pathway Guideline did not require candidates registering with the council to produce a certificate of internship.

He said that in fact, the guideline was specifically for SA citizens who hold qualifications not prescribed for registration and do not meet all the requirements for registration, especially the certificate of good standing from a foreign registering authority equivalent to the HPCSA.

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“Foreign nationals meet this requirement because they practise in their countries before they apply for registration with the HPCSA, whereas SA citizens only obtain qualifications and do not practise as a medical practitioner in foreign countries,” said Nemutandani.

He said the guideline was meant to incorporate foreign-trained doctors into the SA system, even though they did not meet all the requirements for registration.

Nemutandani said the problem with foreign-trained doctors was rooted in the capacity of SA universities to train doctors, as well as quality standards.

Some students opted to go to the Far East to train as doctors, but they were not allowed to touch patients.

“When they come back to SA, we need to ensure they meet the standard in SA. Many African countries are struggling with the same problem.

“If we let in people that are not properly qualified, we are not protecting the public,” he said.

This week, Kalvin Maharaj, a student doctor representing a group of unemployed doctors in KwaZulu-Natal, said there were at least 250 candidates waiting to do internships and community service, but they had to be registered first.

– siphom@citizen.co.za

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